Imaging after liver-directed therapy: evidenced-based update of the LI-RADS treatment response algorithm

There are multiple liver-directed treatment options for hepatocellular carcinoma (HCC), which provide curative intent, help patients achieve remission, and/or provide a bridge to transplant by controlling local tumor progression and downstaging patients. After locoregional therapy (LRT), management of these patients, including liver transplant candidacy, is guided by treatment response assessment. The Liver Imaging Reporting and Data Systems (LI-RADS) treatment response algorithm (TRA) was created to provide a standardized assessment of HCC following LRT. Originally created primarily on expert opinion, subsequent literature has continued to evaluate the validity of this algorithm. In this manuscript, we review emerging literature supporting the use of LI-RADS in the assessment of HCC treatment response after LRT and highlight future updates.