Clinical Benefit of Structured Reporting Using the Liver Imaging Reporting and Data System (LI-RADS) in MRI in Patients at Risk for Hepatocellular Carcinoma

The aim of this study was to evaluate the quality of structured reporting of MRI examinations in patients at risk for HCC using the Liver Imaging Reporting and Data System (LI-RADS) created during the daily clinical routine.In this retrospective study, MRI examinations of 163 patients under HCC surveillance and HCC follow-up were analyzed. The study cohort included a group of 76 patients whose examinations were performed using free-text reporting and a group of 87 patients with structured template reporting based on the LI-RADS criteria. The diagnostic accuracy of the specified LI-RADS category was analyzed for both groups. The impact of structured reporting and the frequency of reporting of the major and ancillary LI-RADS features in free-text reports and structured reports were compared using the χ²-test.Liver lesions were classified according to LI-RADS significantly more often in the structured reports (91.4%) than in the unstructured free-text reports (82.6%) (p < 0.01). Most relevant major LI-RADS criteria were described significantly more frequently when using the structured report template compared to free text, e.g., arterial hyperenhancement 100% vs. 92.5% (p < 0.01) and washout 93.4% vs. 79.7% (p < 0.01). Only the documentation of threshold growth was not significantly improved, but absolute lesion size was reported significantly more often within the structured reports. The diagnostic accuracy of the LI-RADS category was higher for the structured reports than for the free-text reports (82.3% vs. 63.9%).Structured reporting improves LI-RADS documentation in MRI reports of patients at risk for HCC and may help with multidisciplinary communication and patient management. · Structured reporting showed improved documentation of key features for LI-RADS classification compared to nonstructured MRI reports.. · Structured reports improve the categorization of liver lesions according to LI-RADS in patients at risk for HCC.. · Nelles C, Wagner A, Lennartz S et al. Clinical Benefit of Structured Reporting Using the Liver Imaging Reporting and Data System (LI-RADS) in MRI in Patients at Risk for Hepatocellular Carcinoma. Rofo 2026; 198: 209-218.