LI-RADS v2014 features several enhancements:
Updated algorithmic display
Simplified algorithm
Removal of unnecessary decision nodes
Deleted A and B designation in Categories LR-4 and LR-5
Treated observations are identified at the beginning of the algorithm, more reflective of radiologist thought process
Major features are listed in a separate box from the remainder of the table to improve clarity
Expanded and refined LI-RADS lexicon
Expanded illustrative atlas
New material on hepatobiliary agents, imaging technique, management and reporting, including reporting templates for CT and MR
New flash cards for quick reference
Simplified tie-breaking rules to guide assignment of final LI-RADS category
Expanded background material comparing LI-RADS with AASLD and OPTN
LI-RADS v2014 also includes a key modification to achieve congruency between LR-5 and OPTN Class 5 and AASLD:
10-19mm observations with arterial phase hyper-enhancement and one major feature can sometimes be categorized as LR-5 rather than LR-4
Observations with washout appearance and visibility on antecedent surveillance ultrasound meet criteria for HCC using AASLD criteria. These observations can be categorized as LR-5us.
Observations with ≥ 50% diameter increase in ≤ 6 months meet criteria for OPTN 5A-g HCC. These observations can be categorized as LR-5g.