ARRS 2022 Abstracts

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E1982. Ensuring Your LI-RADS Reporting is in MiNT Condition; A Mnemonic for the Often Overlooked LI-RADS Decision Tree
Authors
  1. Deborah Kennedy; University of New Mexico
  2. Masoud Shiehmorteza; University of New Mexico
  3. Steven Eberhardt; University of New Mexico
  4. Nandan Keshav; University of New Mexico
Background
The development of the Liver Reporting and Data System (LI-RADS) has greatly standardized imaging reports for liver lesions in patients at risk for hepatocellular carcinoma (HCC). To ensure there is continued consistency in image interpretation and reporting, one must understand the basics of the LI-RADS grading system, which includes understanding the difference between the decision tree and the decision table. The LI-RADS decision tree is the initial LI-RADS scoring step; however, it is often overlooked because it consists of seemingly unrelated categories. These categories are LR-M, which represents non HCC-malignancies; LR-NC, which represents non-characterizable lesions due to inadequate imaging; and LR-TIV, which represents tumor within a vein. This educational research emphasizes the importance of proper characterization by initially utilizing the LI-RADS decision tree.

Educational Goals / Teaching Points
This exhibit will provide a unique mnemonic for remembering the categories within the LI-RADS decision tree. The mnemonic is “MiNT,” where M represents LR-M, N represents LR-NC, and T represents LR-TIV. Additionally, the LR-M category represents a hepatic lesion that has a significant possibility of being a malignancy other than HCC. There are several imaging features that distinguish LR-M lesions from HCC lesions, and these features can be remembered with the alliteration “M,” for LR-M category. These key imaging features are “marginal” (rim arterial phase hyperenhancement, rim restricted diffusion, rim washout); “mottled” appearance (infiltrative lesions); and “marked” (marked restricted diffusion).

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this presentation, several multiphase imaging examples will be given of lesions within each MiNT category to better recognize and accurately categorize these intrahepatic lesions. Additionally, multiphase imaging examples will be shown of the main LR-M subgroups for easier identification and classification.

Conclusion
This educational review aims at helping simplify the LI-RADS categorization for learners by utilizing the MiNT mnemonic and LR-M, “M” alliteration. Remember that every radiologist wants his or her report to be in “MiNT” condition before diagnosing a patient with HCC.