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Knowledge, attitudes and current practices regarding LI-RADS: A survey from 14 countries in sub-Saharan Africa.

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SA journal of radiology 2026 Vol.30(1) p. 3367
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Segobin R, Creamer D, Khan R, Jonas E, Sobnach S, Moosa S

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[BACKGROUND] Hepatocellular carcinoma (HCC) is highly prevalent in sub-Saharan Africa (SSA).

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APA Segobin R, Creamer D, et al. (2026). Knowledge, attitudes and current practices regarding LI-RADS: A survey from 14 countries in sub-Saharan Africa.. SA journal of radiology, 30(1), 3367. https://doi.org/10.4102/sajr.v30i1.3367
MLA Segobin R, et al.. "Knowledge, attitudes and current practices regarding LI-RADS: A survey from 14 countries in sub-Saharan Africa.." SA journal of radiology, vol. 30, no. 1, 2026, pp. 3367.
PMID 41810164

Abstract

[BACKGROUND] Hepatocellular carcinoma (HCC) is highly prevalent in sub-Saharan Africa (SSA). LI-RADS is a standardised system for imaging-based diagnosis and characterisation of HCC.

[OBJECTIVES] This study assessed knowledge, attitudes and current practices related to LI-RADS in SSA, with a view to identifying barriers to its utilisation and informing targeted educational interventions.

[METHOD] A 21-item anonymous electronic questionnaire was distributed to medical professionals in SSA using the SurveyMonkey online platform. Knowledge, attitudes and current practices regarding LI-RADS were assessed. Data were analysed using descriptive statistics, and comparisons were made between radiologists and non-radiologists.

[RESULTS] There were 134 respondents from 14 of the 34 SSA countries. Radiologists significantly outperformed non-radiologists in LI-RADS knowledge, particularly regarding its purpose (65.6% vs 38.2%, = 0.0007), arterial phase hyperenhancement definition (90.3% vs 59.8%, = 0.004) and size criteria (77.4% vs 45.1%, = 0.003) for diagnosing hepatocellular carcinoma (HCC). However, 43.8% of radiologists and 63.4% of non-radiologists did not recognise the limitations of LI-RADS. Only 34.3% stated that LI-RADS was their reporting standard and 29.1% of the respondents indicated that less than 25% of their radiological reports adhered to LI-RADS. The majority (78.3%) of participants stated they preferred radiology reports for high-risk liver lesions to be LI-RADS-standardised. The two main barriers to adopting LI-RADS included lack of consistency (44.8%) and unfamiliarity with the reporting system (27.6%).

[CONCLUSION] Although LI-RADS remains the preferred reporting system for HCC, there are significant gaps in its knowledge and implementation across SSA.

[CONTRIBUTION] This survey highlights the needs for targeted educational initiatives and improved training to enhance the adoption and use of LI-RADS in SSA.