Diagnosis of hepatocellular carcinoma with MRI

In most cases, hepatocellular carcinoma (HCC) is associated with a known underlying risk factor like chronic viral hepatitis type B and C or alcoholic cirrhosis.1 Patients with chronic liver disease that are at risk for HCC should undergo surveillance ultrasound examinations every 6 months and dynamic cross-sectional imaging like CT and MRI if a detected hepatic nodule exceeds 1 cm in size.2 The established radiological hallmarks for diagnosing HCC non-invasively by imaging—strong contrast uptake in the arterial phase in conjunction with washout in the venous or later phases of dynamic contrast-enhanced studies—as proposed in practice guidelines of different specialised societies (eg, American Association for the Study of the Liver (AASLD) and European Association for the Study of the Liver (EASL) have not been changed for many years.3

Although these imaging features have proven to be very robust with specificities close to 100% even in detecting HCC lesions...

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