Diagnostic performance of the 2024 LI-RADS nonradiation treatment response algorithm in hepatocellular…

Cohort studyEuropean journal of radiology· Jul 2026

Diagnostic performance of the 2024 LI-RADS nonradiation treatment response algorithm in hepatocellular carcinoma treated with locoregional plus immune-targeted therapy.

Hongli Yang, Zhenzhen Zhang, Shuai Han … Xuejun Chen

Abdominal & Body ImagingCohort studyDiagnosisQ1IF 4.0

Adding ancillary features raised LI-RADS sensitivity for detecting viable tumor to 87.1%.

Diagnostic performance of the 2024 LI-RADS nonradiation treatment response algorithm in hepatocellular carcinoma treated with locoregional plus immune-targeted therapy.

Hongli Yang … Xuejun Chen

European journal of radiology · Jul 2026 · Q1 in Radiology

Purpose

To evaluate the diagnostic performance of the Liver Imaging Reporting and Data System (LI-RADS) nonradiation Treatment Response Assessment (Treatment Response Assessment) version 2024 (v2024) in assessing treatment response of hepatocellular carcinoma (hepatocellular carcinoma) following downstaging locoregional therapy (locoregional therapy) plus immune-targeted therapy; to compare its diagnostic performance with LI-RADS Treatment Response Assessment version 2018 (v2018); and to explore the added diagnostic value of its ancillary features (ancillary features).

Methods

This retrospective study included patients with hepatocellular carcinoma who underwent locoregional therapy plus immune-targeted therapy followed by hepatectomy between January 2021 and December 2025.

n = 132 patients

Results

ancillary features boosted tumor detection, catching more viable tumor than v2024 alone

66.3%

Sensitivity

95.2%

Specificity

More results

The LR-TR Viable category of v2024 yielded a sensitivity of 66.3% (95% confidence interval [CI]: 57.1%-75.5%) and a specificity of 95.2% (95% CI: 84.2%-98.7%) for predicting pathologic viability.

More results

For identifying complete pathologic necrosis, the LR-TR Nonviable category showed a sensitivity of 76.2% (95% CI: 63.3%-89.1%) and a specificity of 95.1% (95% CI: 90.8%-99.3%).

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Conclusion

The LI-RADS nonradiation Treatment Response Assessment v2024 incorporating ancillary features showed excellent diagnostic performance and outperformed LI-RADS Treatment Response Assessment v2018 for assessing tumor viability in hepatocellular carcinoma patients treated with locoregional therapy plus immune-targeted therapy.

Diagnostic performance of the 2024 LI-RADS nonradiation treatment response algorithm in hepatocellular carcinoma treated with locoregional plus immune-targeted therapy.

Diagnostic performance of the 2024 LI-RADS nonradiation treatment response algorithm in hepatocellular carcinoma treated with locoregional plus immune-targeted therapy.

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