Screening and Surveillance of Hepatocellular Carcinoma An Introduction to Ultrasound Liver Imaging Reporting and Data System David T. Fetzer, MD a , Shuchi K. Rodgers, MD b , Alison C. Harris, MBChB, FRCR, FRCPC c , Yuko Kono, MD, PhD d,e , Ashish P. Wasnik, MD f , Aya Kamaya, MD g,1 , Claude Sirlin, MD h, * ,1 Disclosures: No author reports relevant commercial or financial conflicts of interest related to the content of this article. The authors disclose the following: speaking and research agreements with Philips Healthcare (D.T. Fetzer); receives royalties from Elsevier (A. Kamaya); industry research grants from Bayer, Guerbet, Siemens, GE, Supersonic, Arterys; research laboratory service agreements with Alexion, AstraZeneca, Bioclinica, BMS, Bracco, Celgene, Fibrogen, Galmed, Genentech, Genzyme, Gilead, Icon, Intercept, Isis, Janssen, NuSirt, Perspec- tum, Pfizer, Profil, Sanofi, Shire, Synageva, Tobira, Takeda, Virtual Scopics (C. Sirlin). a Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390- 8896, USA; b Department of Radiology, Sidney Kimmel Medical College at Thomas Jefferson University, Ein- stein Medical Center, 5501 Old York Road, Philadelphia, PA 19141, USA; c Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, Vancouver, British Columbia V5Z 1M9, Canada; d Department of Medicine, University of California, San Diego, 200 West Arbor Drive, San Diego, CA 92103, USA; e Department of Radiology, University of California, San Diego, 200 West Arbor Drive, San Diego CA 92103, USA; f Department of Radiology, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA; g Department of Radiology, Stanford University, 300 Pasteur Drive, H1307, Stanford, CA 94305, USA; h Liver Imaging Group, Department of Radiology, University of California, San Diego, 9500 Gilman Drive, MC 0888, San Diego, CA 92093-0888, USA 1 Cosenior authors. * Corresponding author. E-mail address: csirlin@ucsd.edu KEYWORDS  Hepatocellular carcinoma  HCC  Screening  Surveillance  Ultrasound  Reporting KEY POINTS  Hepatocellular carcinoma has a high prevalence among populations with cirrhosis, is increasing in incidence, and is associated with significant morbidity and mortality. Therefore, a robust screening and surveillance program is needed.  Most societies advocate ultrasound as the first-line screening and surveillance modality for at-risk populations, despite variability in sensitivity, which may in part be caused by the inherent user dependence and variability in performance between individuals and sites. A standardized imaging protocol, reporting language, and set of management recommendations may significantly improve patient care; this is the basis behind the American College of Radiology (ACR) Ultrasound Liver Im- aging Reporting and Data System (US LI-RADS) for screening and surveillance.  This article provides an introduction to US LI-RADS, discusses the applicable target population and impact on clinical work flow and patient management, and offers example cases and images. Radiol Clin N Am 55 (2017) 1197–1209 http://dx.doi.org/10.1016/j.rcl.2017.06.012 0033-8389/17/Ó 2017 Elsevier Inc. All rights reserved. radiologic.theclinics.com