Aperivue RADS

Liver Imaging Report Generator

Structured reporting with LI-RADS CT/MRI v2018 · Multi-observation · PACS-ready output

Calculator inputs are in English. Complete the fields below to generate a PACS-ready report.

Technique

Set the modality and contrast agent for the whole study. Diagnostic adequacy (the LR-NC gate) is assessed per observation below.

Contrast agent

Observation Assessment

Observations

Major Features

Arterial phase hyperenhancement (APHE)

Tumor in Vein / Benignity
LR-M Features (probably/definitely malignant, not HCC-specific)

Rim APHE is selected above. Any feature here assigns LR-M.

Ancillary Features

Favoring malignancy can upgrade by one category (never to LR-5); favoring benignity can downgrade. Both present → no adjustment.

Favoring malignancy

Favoring benignity

Select APHE and enter observation size to see the LI-RADS category.

Auto-generated from observations

CONTRAST-ENHANCED MRI OF THE LIVER — LI-RADS v2018

TECHNIQUE: Multiphase MRI with Extracellular agent (ECA).
CLINICAL CONTEXT: LI-RADS applicable high-risk context assumed (specify cirrhosis, chronic HBV, or current/prior HCC).
COMPARISON: None available.

FINDINGS:

Liver observations:
1. Observation 1 (Not specified):
   Incomplete input — select APHE and enter size to categorize.

IMPRESSION:
No categorizable LI-RADS observation. Correlate with clinical findings and complete the observation inputs.

LI-RADS CT/MRI v2018 — diagnostic categories

HCC probability and management by ACR CT/MRI LI-RADS v2018 category. Mirrors the categories assigned by the calculator above.

CategoryHCC probabilityTypical management
LR-1Definitely benignReturn to routine surveillance (e.g., 6-month imaging).
LR-2Probably benignSurveillance imaging, generally in 6 months.
LR-3Intermediate probability of malignancyRepeat or alternative diagnostic imaging in 3–6 months.
LR-4Probably HCCMultidisciplinary discussion; consider biopsy or repeat/alternative imaging.
LR-5Definitely HCCBiopsy not required; multidisciplinary management.
LR-MProbably/definitely malignant, not HCC-specificMultidisciplinary discussion; biopsy usually required.
LR-TIVDefinite tumor in veinMultidisciplinary discussion; treat as malignant.
LR-NCCannot be categorizedRepeat or alternative imaging, generally within 3 months.

Key decision rules (CT/MRI v2018)

  • LI-RADS v2018 applies only to patients at high risk for HCC (cirrhosis, chronic HBV, or current/prior HCC); it is not used in the general population.
  • The diagnostic table combines the major features — nonrim APHE, nonperipheral washout, enhancing capsule, and threshold growth — with observation size to assign LR-3 through LR-5.
  • LR-M is assigned for targetoid or rim-APHE features that favor a malignancy other than HCC, and takes precedence over the diagnostic table.
  • LR-TIV indicates definite tumor in vein (enhancing soft tissue within a vessel).
  • LR-NC is assigned when the study cannot be categorized because of image omission or degradation.
  • Ancillary features can adjust the category by up to one step (up for malignancy, down for benignity) but cannot raise an observation to LR-5.

Disclaimer: This tool is for educational and research purposes only. It is not a medical device and has not been cleared or approved by the FDA, KFDA/MFDS, or any regulatory authority. It is not intended for clinical diagnosis or treatment decisions. It does not replace professional medical judgment. LI-RADS applies only to patients at high risk for HCC. Always correlate with clinical findings and institutional protocols.

Reference: References: ACR CT/MRI LI-RADS v2018 Core. Chernyak V, et al. Liver Imaging Reporting and Data System (LI-RADS) Version 2018. Radiology. 2018;289(3):816-830.