A 50-year-old man with chronic liver disease undergoes multiphasic CT for hepatocellular carcinoma surveillance. A 1.5 cm nodule in segment VI shows arterial phase hyperenhancement and washout on the portal venous phase. According to the Liver Imaging Reporting and Data System (LI-RADS), what is the appropriate classification for this finding?

• A LR-5 (definitely HCC) ✓
• B LR-4 (probably HCC)
• C LR-3 (intermediate probability of HCC)
• D LR-M (probably or definitely malignant, not specific for HCC)

Explanation

LI-RADS classifies a nodule 10 mm or larger with arterial phase hyperenhancement and washout as LR-5, meaning definitely HCC. LR-4 requires one additional major feature such as capsule enhancement or threshold growth. LR-3 is for nodules with non-rim arterial hyperenhancement without washout. LR-M is reserved for lesions with features suggesting malignancy but not specific for HCC, such as infiltrative appearance or marked restricted diffusion.

Reference: LI-RADS v2018, American College of Radiology, 2018 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.