LIRADS 3 - Enigma

LI-RADS v2018 DSEA

Architected by Dr. Sharad Maheshwari MD

Offline Edge

N/A

1. Target Population

Relation to prior HCC? De novo (New observation elsewhere) Treated Site (At/adjacent to prior treatment)

2. Experimental Lexicon (2026)

Beta

Does the observation have a true mass-like morphology?

3. Modality & Major Features

Modality CT or Extracellular MRI Gadoxetate (HBA) MRI

⚠️ HBA Selected: Assess washout on portal venous phase ONLY.

Size (mm)

Arterial Phase (APHE) No APHE Nonrim APHE Rim APHE

Additional Major Features

4. Targetoid Features (LR-M)

5. Ancillary Features

Discretionary tie-breakers. Cannot upgrade LR-4 to LR-5.

Favoring Malignancy / HCC

Favoring Benignity

6. Adjunct Labs (MDT Context)

AFP (ng/mL)

AFP-L3 (%)

PIVKA-II (mAU)

Diagnostic Category

N/A

Shifted via Ancillary to:

Reasoning Trace

Management