MRI of Infiltrative HCC- Characterization of Imaging Features in Association with Clinical Presentation

Bobby Kalb¹, Douglas Vander Kooi², Daniel Karolyi¹, Bhavika Patel¹, Khalil Salman¹, Diego R. Martin¹

Infiltrative-type of HCC (I-HCC) is an incurable, less common growth pattern of HCC that may mimic fulminant CLD. Distinction of I-HCC on MRI is critical for optimal management and to avoid inadvertent transplantation of incurable disease, however imaging features may be atypical with poor visibility of tumor extent on postcontrast images. We have categorized MR imaging and pathologic features of I-HCC, and found tumor conspicuity to be most pronounced on T2-weighted images, with portal venous tumor thrombus present in all cases. These findings are important to help improved clinical application of MRI in the setting of CLD.