Our retrospective study investigated the utility of Liver Imaging Reporting and Data System (LI-RADS) v2017 for combined hepatocellular cholangiocarcinoma (cHCC-CCs) in the differential diagnosis from HCCs and prediction of prognosis. Using LI-RADS on gadoxetic acid-enhanced MRI, among cHCC-CCs (n=70), 61.4% (43/70) were accurately categorized as LR-M (probable malignancy, not specific for HCC) while 37.1% (26/70) as LR-5/4 (definitely/probably HCC); among HCCs (n=70), 88.6% (62/70) and 10.0% (7/70) were categorized as LR-5/4 and LR-M, respectively. After surgical resection, patients with LR-M cHCC-CCs showed a higher early recurrence rate (≤6 months) than those with LR-5/4 cHCC-CCs (27.8% (10/36) vs. 4.8% (1/21), P=0.041).
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