CT and MRI LI-RADS Treatment Response Assessment 2024: Core Concepts for Clinical Practice

For management of hepatocellular carcinoma (HCC), locoregional therapies are commonly used as curative interventions, bridging strategies before a liver transplant, or methods to reduce the tumor burden. After treatment, imaging surveillance is essential to guiding subsequent patient treatment decisions by enabling timely detection of recurrence or residual tumor viability. However, imaging interpretation can be challenging due to variability in expected findings, based on the treatment modality, response achieved, and time since therapy. The CT and MRI Liver Imaging Reporting and Data System (LI-RADS) treatment response assessment algorithm was developed to standardize imaging interpretation and reporting after locoregional therapy for primary liver malignancies. Integrating emerging evidence and feedback from clinical users, the updated 2024 treatment response assessment algorithm establishes distinct criteria for nonradiation- and radiation-based therapies and includes ancillary MRI features to improve detection of tumor viability. The authors review the updated LI-RADS treatment response assessment algorithm, with particular attention to clinical applicability and implications for patient care. © The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license. Supplemental material is available for this article.