User and system pitfalls in liver imaging with LI-RADS

Khaled M. Elsayes, Kathryn J. Fowler, Victoria Chernyak, Mohab M. Elmohr, Ania Z. Kielar, Elizabeth Hecht, Mustafa R. Bashir, Alessandro Furlan, Claude B. Sirlin

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


The Liver Imaging Reporting and Data System (LI-RADS) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver imaging, created specifically for patients at risk for hepatocellular carcinoma. Over the past years, LI-RADS has been progressively implemented into clinical practice, but pitfalls remain related to user error and inherent limitations of the system. User pitfalls include the inappropriate application of LI-RADS to a low-risk patient population, incorrect measurement techniques, inaccurate assumptions about LI-RADS requirements, and improper usage of LI-RADS terminology and categories. System pitfalls include areas of discordance with the Organ Procurement and Transplantation Network (OPTN) as well as pitfalls related to rare ancillary features. This article reviews common user pitfalls in applying LI-RADS v2018 and how to avoid preventable errors and also highlights deficiencies of the current version of LI-RADS and how it might be improved in the future. Level of Evidence:3. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2019. J. Magn. Reson. Imaging 2019;50:1673–1686.

Original languageEnglish (US)
Pages (from-to)1673-1686
Number of pages14
JournalJournal of Magnetic Resonance Imaging
Issue number6
StatePublished - Dec 1 2019


  • CT
  • MRI
  • hepatocellular carcinoma
  • liver
  • pitfalls

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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