Contrast-enhanced Ultrasound LI-RADS for Nonradiation Treatment Response Assessment in Liver Tumor: A Pictorial Review Based on LR-TR v2024

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This pictorial review summarizes the Contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) Treatment Response Algorithm (LR-TR, v2024) for response assessment after nonradiation locoregional therapies (NLT). The NLT covered by LR-TR v2024 includes embolization procedures such as conventional transarterial chemoembolization (cTACE), drug-eluting bead TACE (DEB-TACE), and bland transarterial embolization (TAE), as well as ablation techniques such as radiofrequency ablation (RFA), microwave ablation (MWA), and percutaneous ethanol injection (PEI). The algorithm independently evaluates intralesional and perilesional viability, using arterial-phase enhancement as the dominant criteria for intralesional evaluation and multiphasic enhancement (arterial, portal, and late phases) for perilesional evaluation. The results are then integrated into three standardized response categories, including LR-TR Viable, Equivocal, or Nonviable. Evidence from multicenter studies in hepatocellular carcinoma (HCC) indicates that CEUS LR-TR v2024 provides high reliability and strong reproducibility in detecting residual viable tumor following NLT. This review provides representative imaging features and interpretation tips to familiarize physicians with CEUS LR-TR v2024, aiming to improve accuracy in treatment response assessment (TRA) in HCC and facilitate timely therapeutic adjustments that ultimately benefits patients.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.