With the rising incidence of hepatocellular carcinoma, there has been increasing use of local-regional therapy (LRT) to downstage or bridge to transplant, for definitive treatment, and for palliation. The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) Treatment Response Assessment (TRA) algorithm provides guidance for step-by-step tumor assessment after LRT and standardized reporting. Current evidence suggests that the algorithm performs well in the assessment of tumor response to arterial embolic and loco-ablative therapies and fair when assessing response to radiation-based therapies, with limited data to validate the latter. Both evidence-based and expert-based refinements of the algorithm are needed to improve its diagnostic accuracy after varying types of LRT. This review provides an overview of the challenges and limitations of the LI-RADS TRA algorithm version 2017 and discusses the refinements introduced in the updated 2024 LI-RADS algorithm for CT/MRI.

中文翻译：

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CT/MRI LI-RADS 2024 更新：治疗反应评估。


随着肝细胞癌发病率的上升，越来越多地使用局部区域疗法 （LRT） 来降低移植期或过渡到移植、根治性治疗和姑息治疗。CT/MRI 肝脏影像学报告和数据系统 （LI-RADS） 治疗反应评估 （TRA） 算法为 LRT 和标准化报告后的分步肿瘤评估提供指导。目前的证据表明，该算法在评估肿瘤对动脉栓塞和局部消融治疗的反应方面表现良好，在评估对基于放疗的反应时表现良好，验证后者的数据有限。需要对算法进行基于证据和基于专家的改进，以提高其在不同类型的 LRT 后的诊断准确性。本综述概述了 LI-RADS TRA 算法 2017 版的挑战和局限性，并讨论了更新的 2024 年 CT/MRI LI-RADS 算法中引入的改进。