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E1831. LI-RADS Technical Recommendations for Liver Imaging: Pitfalls, Challenges and Tips and Tricks for Success
Authors
  1. Alice Fung; Oregon Health & Science University
  2. Kathryn Fowler; UC San Diego
  3. Hero Hussain; American University of Beirut Medical Center
  4. Vahid Yaghmai; University of California, Irvine
  5. Avinash Kambadakone-Ramesh; Massachusetts General Hospital
Background
Accurate detection and characterization of liver observations in patients at risk for hepatocellular carcinoma (HCC) requires optimal CT/MR imaging technique. Adhering to the Liver Reporting and Data System (LI-RADS®) technical recommendations allows standardization of liver imaging and quality across imaging centers and reduces the possibility of liver observations being miscategorized or deemed noncategorizable (NC). In addition, despite adherence to the technical recommendations, certain pitfalls and artifacts can result in suboptimal CT and MR image quality. Understanding these challenges can allow the radiologist and/or technologist to proactively identify potential problems to ameliorate their effects. The purpose of this exhibit is to review LI-RADS® technical recommendations for CT and MRI and to review commonly encountered pitfalls and challenges with liver imaging and offer potential solutions.

Educational Goals / Teaching Points
This exhibit will address the following: a brief review of the LI-RADS® technical recommendations for CT and MRI followed by a case-based illustration of common challenges encountered in liver imaging that degrade image quality. Etiologies and potential solutions for these challenges will be described.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Suboptimal arterial phase timing, motion artifact, misregistration of subtraction imaging, DWI blind spots, dielectric effect and conductive effects, transient severe motion, the value of delayed phase imaging, motion artifact, hepatobiliary phase imaging challenges

Conclusion
Adhering to optimal CT and MRI liver imaging technique and understanding commonly encountered pitfalls in liver imaging and their solutions allow the radiologist to accurately categorize observations using LI-RADS® and, thus, provide high-quality patient care.