The purpose of this study is to determine in cirrhotic patients the proportion of MRI-diagnosed TIV cases with parenchymal masses, the proportion of cases due to HCC or non-HCC malignancy, and whether assessment of the parenchymal mass allows differentiation of the malignancy type. All TIV cases had parenchymal masses. Using a composite reference standard and excluding tumors with no reference standard, the underlying malignancy was HCC in 91% (41/45), ICC in 4% (2/45), and H-ChC in 4% (2/45). LI-RADS categorization of the parenchymal mass may help identify patients in whom TIV is not due to HCC. In particular, patients with TIV and LR-M parenchymal masses may need biopsy to exclude non-HCC malignancy.