LI-RADS v2018 versus KLCA-NCC v2022: comparison of probability-based HCC categories
By
Jeong Hee Yoon
Eun Sun Lee
Young Kon Kim
Chang Hee Lee
Jeong Woo Kim
Won Chang
Joon-Il Choi
Beom Jin Park
Jin-Young Choi
Seung-seob Kim
Jeong-Sik Yu
Seong Jin Park
Myung-Won You
Myoung-jin Jang
Hee Sun Park
Jeong Min Lee
June 26, 2026
Clinical Scorecard: Comparison of Probability-Based HCC Classification: LI-RADS v2018 and KLCA-NCC v2022
At a Glance
Category Detail
Condition Hepatocellular carcinoma (HCC) Key Mechanisms Non-rim arterial-phase hyperenhancement (APHE) and non-peripheral washout are key imaging characteristics. Target Population HCC-naïve patients with chronic hepatitis B or C, or cirrhosis of any etiology. Care Setting Tertiary hospitals conducting gadoxetic acid-enhanced MRI.
Key Highlights
LI-RADS v2018 and KLCA-NCC v2022 categorize hepatic observations based on HCC probability. LI-RADS uses four major features for categorization, while KLCA-NCC emphasizes transitional and hepatobiliary phases. Both systems include categories for definite HCC, probable HCC, and indeterminate nodules. Guideline-Based Recommendations
Diagnosis
LI-RADS v2018 categorizes observations from LR-3 to LR-5 based on imaging features. KLCA-NCC v2022 requires non-rim APHE and non-peripheral washout for probable HCC. Management
Accurate categorization is critical for management decisions. Monitoring & Follow-up
Follow-up imaging is required for benign lesions to confirm stability or decrease in size. Risks
Limited evidence supporting equivalence of diagnostic criteria between LI-RADS and KLCA-NCC. Patient & Prescribing Data
Patients with chronic liver disease undergoing imaging for suspected HCC.
Gadoxetic acid-enhanced MRI is utilized for improved diagnostic accuracy.
Clinical Best Practices
Utilize both LI-RADS and KLCA-NCC guidelines for comprehensive HCC assessment. Ensure histological confirmation of malignant lesions within 90 days post-MRI. Related Resources & Content
