ARCHETYPE LI-RADS (openEHR-EHR-CLUSTER.lirads.v1)

ARCHETYPE IDopenEHR-EHR-CLUSTER.lirads.v1
ConceptLI-RADS
DescriptionThe Liver Imaging Reporting and Data System (LI-RADS®) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver observations in individuals at high risk for hepatocellular carcinoma (HCC).
UseThis archetype will be used to present the standardized reporting and data collection of CT and MRI imaging, and ultrasound for hepatocellular carcinoma (HCC). LI-RADS uses specific imaging features of the lesion in question to identify the degree of suspicion for malignancy. This cluster can be used in the slot "Imaging result" of the superordinate archetype "Imaging examination result" (openEHR-EHR-OBSERVATION.imaging_exam_result).
MisuseNot to be used for the documentation for patients without the risk factors of developing a hepatocelluar carcinoma, or for patients under 18 years of age. Not to be used for the documentation of suspiction of any other lieson in the liver. Not to be used for the documentation of lesions in any other body organ.
Purposefor presentration of the standardized reporting and data collection of CT, MRI imaging and ultrasound for hepatocellular carcinoma (HCC).
References1. Elsayes K, Kielar A, Chernyak V, Morshid A, Furlan A, Masch W, Marks R, Kamaya A, Do R, Kono Y, Fowler K, Tang A, Bashir M, Hecht E, Jambhekar K, Lyshchik A, Rodgers S, Heiken J, Kohli M, Fetzer D, Wilson S, Kassam Z, Mendiratta-Lala M, Singal A, Lim C, Cruite I, Lee J, Ash R, Mitchell D, McInnes M, Sirlin C. <p>LI-RADS: a conceptual and historical review from its beginning to its recent integration into AASLD clinical practice guidance</p>. Journal of Hepatocellular Carcinoma. 2019;Volume 6:49-69.

2. LI-RADS [Internet]. Acr.org. 2020. Available from: https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS

3. Schima W, Heiken J. LI-RADS v2017 for liver nodules: how we read and report. Cancer Imaging [Internet]. 2018;18(1). Available from: https://cancerimagingjournal.biomedcentral.com/articles/10.1186/s40644-018-0149-5

4. Morgan M. LI-RADS | Radiology Reference Article | Radiopaedia.org [Internet]. Radiopaedia.org. 2020 [cited 2020 Mar 9]. Available from: https://radiopaedia.org/articles/li-rads
Copyright© HiGHmed
AuthorsAuthor name: Samer Alkarkoukly
Organisation: Uniklinik Köln
Email: Mabbouda@uni-koeln.de
Other Details LanguageAuthor name: Samer Alkarkoukly
Organisation: Uniklinik Köln
Email: Mabbouda@uni-koeln.de
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/., custodian_organisation=HiGHmed, references=1. Elsayes K, Kielar A, Chernyak V, Morshid A, Furlan A, Masch W, Marks R, Kamaya A, Do R, Kono Y, Fowler K, Tang A, Bashir M, Hecht E, Jambhekar K, Lyshchik A, Rodgers S, Heiken J, Kohli M, Fetzer D, Wilson S, Kassam Z, Mendiratta-Lala M, Singal A, Lim C, Cruite I, Lee J, Ash R, Mitchell D, McInnes M, Sirlin C.

LI-RADS: a conceptual and historical review from its beginning to its recent integration into AASLD clinical practice guidance

. Journal of Hepatocellular Carcinoma. 2019;Volume 6:49-69. 2. LI-RADS [Internet]. Acr.org. 2020. Available from: https://www.acr.org/Clinical-Resources/Reporting-and-Data-Systems/LI-RADS 3. Schima W, Heiken J. LI-RADS v2017 for liver nodules: how we read and report. Cancer Imaging [Internet]. 2018;18(1). Available from: https://cancerimagingjournal.biomedcentral.com/articles/10.1186/s40644-018-0149-5 4. Morgan M. LI-RADS | Radiology Reference Article | Radiopaedia.org [Internet]. Radiopaedia.org. 2020 [cited 2020 Mar 9]. Available from: https://radiopaedia.org/articles/li-rads, original_namespace=org.highmed, original_publisher=HiGHmed, custodian_namespace=org.highmed, MD5-CAM-1.0.1=7FDFF0C32EBD83A948594CCEC6221B51, build_uid=1b0df69a-143a-4c4c-b781-639885855942, revision=1.0.2-alpha}
KeywordsLI-RADS, CT, MRI, HCC, Liver imaging, ultrasound, CEUS, hepatocellular carcinoma, American College of Radiology, ACR
Lifecyclein_development
UIDc9823839-1f3a-4cac-be47-8a62d3777100
Language useden
Citeable Identifier1246.145.1027
Revision Number1.0.2-alpha
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=The Liver Imaging Reporting and Data System (LI-RADS®) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver observations in individuals at high risk for hepatocellular carcinoma (HCC)., archetypeConceptComment=null, otherContributors=, originalLanguage=en, translators=
  • German: Samer Alkarkoukly, Uniklinik Köln, mabbouda@uni-koeln.de

    • , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={target=[], description=[], activities=[], other_participations=[], details=[], provider=[], state=[], items=[ResourceSimplifiedHierarchyItem [path=/items[at0003], code=at0003, itemType=ELEMENT, level=1, text=LI-RADS algorithm, description=The algorithm used to assess and diagnose liver lesions in a patient at risk of HCC., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Ultrasound LI-RADS [For monitoring. Using conventional sonography. In patients with liver cirrhosis and other high-risk patients.]
    • CEUS LI-RADS [For HCC diagnostics. Using contrast-enhanced ultrasound (KMUS, contrast-enhanced.]
    • CT/MRI Diagnostic LI-RADS [For HCC diagnosis and staging. In patients with liver cirrhosis and other high-risk patients including transplant candidates with HCC.]
    • CT/MRI therapy response LI-RADS [To assess HCC therapy response to locoregional therapy. In patients with liver cirrhosis and other high-risk patients including transplant candidates with HCC. Using CT, MRI with extracellular contrast agents (ECA), or MRI with hepatobiliary contrast agents (HBA).]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0008], code=at0008, itemType=ELEMENT, level=1, text=LI-RADS Version, description=The year of the LI-RADS version used to assess and diagnose the patient., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0009], code=at0009, itemType=ELEMENT, level=1, text=Diagnostic category, description=The LI-RADS category is a score assigned to a focal lesion. The categories span the spectrum of benign to malignant observations occurring in patients with chronic liver disease at risk for cirrhosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • LR-NC [If assessment is not possible due to missing or poor imaging.]
    • LR-TIV [If there is definitive evidence of tumor infiltration into the vein (TIV).]
    • LR-1 [If definitely benign.]
    • LR-2 [If probably benign.]
    • LR-3 [With medium probability of malignancy.]
    • LR-4 [If probably HCC.]
    • LR-5 [Wenn definitiv HCC.]
    • LR-M [If probably or definitely malignant but not HCC-specific (e.g. bull's-eye sign).]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0018], code=at0018, itemType=ELEMENT, level=1, text=Therapy response category, description=The categories of therapy response (TR) are used to assess the tumor's response after a locoregional therapy., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • LR-TR Not assessable [Treated, response not assessable (due to lack of imaging or poor quality).]
    • LR-TR nonviable [Treated, probably or definitely nonviable.]
    • LR-TR not clear [Treated, not clearly vital.]
    • LR-TR vital [Treated, probably or definitely vital.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0023], code=at0023, itemType=ELEMENT, level=1, text=Arterial hypervascularization (APHE), description=The enhancement in the arterial phase, which is clearly higher than that of the liver., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • No APHE [No contrast enhancement in the arterial phase.]
    • APHE (no rim character) [Contrast enhancement in the arterial phase, non-marginal.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0027], code=at0027, itemType=ELEMENT, level=1, text=Size of the observation, description=The size of the observed nodule or lesion in the liver., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
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      Property: Length
      Units: mm
    •  Text
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0028], code=at0028, itemType=ELEMENT, level=1, text=Enhancing capsule, description=Peripheral edge of a smooth hyperenhancement in the portal venous phase, transition phase or delayed phase., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Yes [With enhancing capsule.]
    • No [Without enhancing of the capsule.]
    • Unknown [Cannot be evaluated or not clear.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0031], code=at0031, itemType=ELEMENT, level=1, text=“Washout” (not peripheral), description=A visual assessment of the relative hypointensity of the lesion compared to the background liver in the portal venous and delayed phases., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Yes [With washout.]
    • No [Without washout.]
    • Unknown [Cannot be evaluated or not clear.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0034], code=at0034, itemType=ELEMENT, level=1, text=Threshold growth, description=Diameter increase ≥50% increase in ≤6 months. Other previous criteria are now considered subthreshold growth, an additional feature (if the previous examination lasts >6 months, the diameter increases ≥100%, or if a new lesion ≥10 mm arises in <24 months)., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Yes [With threshold growth.]
    • No [Without threshold growth.]
    • Unknown [Cannot be evaluated or not clear.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0037], code=at0037, itemType=ELEMENT, level=1, text=Vascular involvement, description=The presence of clear improving soft tissue in the vessel lumen., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Yes [With vascular involvement.]
    • No [Without vascular involvement.]
    • Unknown [Cannot be evaluated or not clear.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0040], code=at0040, itemType=ELEMENT, level=1, text=Comment, description=Additional information about the report that has not yet been documented elsewhere., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], protocol=[], data=[], ism_transition=[], relationships=[], credentials=[], context=[], events=[], capabilities=[], contacts=[], content=[], identities=[], source=[]}, topLevelItems={items=ResourceSimplifiedHierarchyItem [path=ROOT_/, code=at0000, itemType=CLUSTER, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=items, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/items[at0003], code=at0003, itemType=ELEMENT, level=1, text=LI-RADS algorithm, description=The algorithm used to assess and diagnose liver lesions in a patient at risk of HCC., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Ultrasound LI-RADS [For monitoring. Using conventional sonography. In patients with liver cirrhosis and other high-risk patients.]
    • CEUS LI-RADS [For HCC diagnostics. Using contrast-enhanced ultrasound (KMUS, contrast-enhanced.]
    • CT/MRI Diagnostic LI-RADS [For HCC diagnosis and staging. In patients with liver cirrhosis and other high-risk patients including transplant candidates with HCC.]
    • CT/MRI therapy response LI-RADS [To assess HCC therapy response to locoregional therapy. In patients with liver cirrhosis and other high-risk patients including transplant candidates with HCC. Using CT, MRI with extracellular contrast agents (ECA), or MRI with hepatobiliary contrast agents (HBA).]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0008], code=at0008, itemType=ELEMENT, level=1, text=LI-RADS Version, description=The year of the LI-RADS version used to assess and diagnose the patient., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0009], code=at0009, itemType=ELEMENT, level=1, text=Diagnostic category, description=The LI-RADS category is a score assigned to a focal lesion. The categories span the spectrum of benign to malignant observations occurring in patients with chronic liver disease at risk for cirrhosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • LR-NC [If assessment is not possible due to missing or poor imaging.]
    • LR-TIV [If there is definitive evidence of tumor infiltration into the vein (TIV).]
    • LR-1 [If definitely benign.]
    • LR-2 [If probably benign.]
    • LR-3 [With medium probability of malignancy.]
    • LR-4 [If probably HCC.]
    • LR-5 [Wenn definitiv HCC.]
    • LR-M [If probably or definitely malignant but not HCC-specific (e.g. bull's-eye sign).]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0018], code=at0018, itemType=ELEMENT, level=1, text=Therapy response category, description=The categories of therapy response (TR) are used to assess the tumor's response after a locoregional therapy., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • LR-TR Not assessable [Treated, response not assessable (due to lack of imaging or poor quality).]
    • LR-TR nonviable [Treated, probably or definitely nonviable.]
    • LR-TR not clear [Treated, not clearly vital.]
    • LR-TR vital [Treated, probably or definitely vital.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0023], code=at0023, itemType=ELEMENT, level=1, text=Arterial hypervascularization (APHE), description=The enhancement in the arterial phase, which is clearly higher than that of the liver., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • No APHE [No contrast enhancement in the arterial phase.]
    • APHE (no rim character) [Contrast enhancement in the arterial phase, non-marginal.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0027], code=at0027, itemType=ELEMENT, level=1, text=Size of the observation, description=The size of the observed nodule or lesion in the liver., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
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      Property: Length
      Units: mm
    •  Text
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0028], code=at0028, itemType=ELEMENT, level=1, text=Enhancing capsule, description=Peripheral edge of a smooth hyperenhancement in the portal venous phase, transition phase or delayed phase., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Yes [With enhancing capsule.]
    • No [Without enhancing of the capsule.]
    • Unknown [Cannot be evaluated or not clear.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0031], code=at0031, itemType=ELEMENT, level=1, text=“Washout” (not peripheral), description=A visual assessment of the relative hypointensity of the lesion compared to the background liver in the portal venous and delayed phases., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Yes [With washout.]
    • No [Without washout.]
    • Unknown [Cannot be evaluated or not clear.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0034], code=at0034, itemType=ELEMENT, level=1, text=Threshold growth, description=Diameter increase ≥50% increase in ≤6 months. Other previous criteria are now considered subthreshold growth, an additional feature (if the previous examination lasts >6 months, the diameter increases ≥100%, or if a new lesion ≥10 mm arises in <24 months)., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Yes [With threshold growth.]
    • No [Without threshold growth.]
    • Unknown [Cannot be evaluated or not clear.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0037], code=at0037, itemType=ELEMENT, level=1, text=Vascular involvement, description=The presence of clear improving soft tissue in the vessel lumen., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
    • Yes [With vascular involvement.]
    • No [Without vascular involvement.]
    • Unknown [Cannot be evaluated or not clear.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0040], code=at0040, itemType=ELEMENT, level=1, text=Comment, description=Additional information about the report that has not yet been documented elsewhere., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]