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Abstract #1170

Enhanced Diagnostic Accuracy for Subcentimeter HCC Using Integrated AFP and Gadolinium-Based MRI Features

Haoran Dai1, Xuying Chen1,2, Chun Yang1, and Mengsu Zeng1
1Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China, 2Department of MRI, Da Qing Oilfield General Hospital, Daqing, China

Synopsis

Keywords: Liver, Liver, Hepatocellular Carcinoma (HCC); LI-RADS; Contrast-Enhanced Magnetic Resonance Imaging (CE-MRI); Diagnostic Criteria; Alpha-Fetoproteins

Motivation: Current diagnostic criteria for subcentimeter HCC lack sufficient sensitivity, leading to delayed detection and poorer outcomes.

Goal(s): To evaluate the diagnostic performance of LI-RADS v2018 and r-LI-RADS for subcentimeter HCC and to develop a new criterion integrating serum AFP levels and gadolinium-based CE-MRI features.

Approach: Retrospective study of 179 patients with 92 pathologically confirmed HCC and 87 non-HCC lesions (<1 cm), using conventional gadolinium contrast. Optimal AFP threshold and logistic regression identified predictors.

Results: New criterion with ≥3 positive factors (AFP > 12.15 ng/mL, non-peripheral arterial phase enhancement, diffusion restriction, fat deposition, enhancing capsule) achieved 78.3% sensitivity, surpassing LR-4, r-LR-5/4, and r-LR-4.

Impact: Enhances diagnostic sensitivity for subcentimeter HCC, improving early detection and patient outcomes.

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