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The Liver Imaging Reporting and Data System (LI-RADS) standardizes the interpretation, reporting, and data collection for imaging examinations in patients at risk for hepatocellular carcinoma (HCC). It assigns category codes reflecting relative probability of HCC to imaging-detected liver observations based on major and ancillary imaging features. LI-RADS also includes imaging features suggesting malignancy other than HCC. Supported and endorsed by the American College of Radiology (ACR), the system has been developed by a committee of radiologists, hepatologists, pathologists, surgeons, lexicon experts, and ACR staff, with input from the American Association for the Study of Liver Diseases and the Organ Procurement Transplantation Network/United Network for Organ Sharing. Development of LI-RADS has been based on literature review, expert opinion, rounds of testing and iteration, and feedback from users. This article summarizes and assesses the quality of evidence supporting each LI-RADS major feature for diagnosis of HCC, as well as of the LI-RADS imaging features suggesting malignancy other than HCC. Based on the evidence, recommendations are provided for or against their continued inclusion in LI-RADS. © RSNA, 2017 Online supplemental material is available for this article.

Chronic liver disease remains a substantial worldwide problem. Accurate estimation of liver fibrosis is crucial for determining the stage of the disease, assessing the patient's prognosis and predicting treatment response. Staging hepatic fibrosis has traditionally been done with liver biopsy but clinical practice has been changing, partly because liver biopsy has several disadvantages: it is invasive; it is associated with rare but serious complications; and it is prone to sampling error representing a tiny portion of the total liver volume. An increasing number of non-invasive liver fibrosis assessment have been developed. These include elastographic methods involving ultrasound (US) and magnetic resonance (MR) imaging. In this review article we discuss the different ultrasound-based elastography techniques, their clinical applications and various confounding factors in the assessment of hepatic fibrosis that may affect the accuracy of the measurements. [ABSTRACT FROM AUTHOR]

Background: Ventriculogallbladder (VGB) shunts are currently placed as a salvage procedure in treatment of hydrocephalus when all other options are exhausted. Although VGB shunts work well when successfully implanted, they are still rarely used because of the technical challenges with the traditional surgical technique., Objective: To implant VGB shunts using a minimally invasive technique that is safer and less technically challenging., Methods: We discussed our utilization of a percutaneous transhepatic approach to placement of the distal catheter into the gallbladder as a new technique that offers a solution to the established but surgically demanding current approach. We presented a complex patient with multiple failed shunts who underwent placement of a VGB shunt., Results: The shunt was successfully placed and did not incur any complications or require any revisions in 5 yr., Conclusion: Given the safety and ease of this minimally invasive approach, we believe percutaneous transhepatic approach in VGB shunts should be considered as a reasonable option in patients with complex hydrocephalus., (Copyright © Congress of Neurological Surgeons 2021. All rights reserved.)