Diagnosis of hepatocellular carcinoma (HCC) is largely based on imaging. MRI is ideally suited for the non-invasive diagnosis of HCC because it has numerous tissue contrast mechanisms and is the only modality that can assess all major and ancillary imaging features. We evaluated the diagnostic performance of MRI-determined LI-RADS major features, ancillary features, and categories for the diagnosis of HCC. Our results suggest that interpretation that includes ancillary features increases the sensitivity, while preserving a high specificity for definite HCC and a slightly lower specificity for probable HCC. Further, ancillary features in favor of benign entities have high specificity for benignity.
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