Purpose: Microvascular invasion (MVI) is an important prognostic factor in patients with hepatocellular carcinoma (HCC). However, the reported results of magnetic resonance imaging (MRI) features for predicting MVI of HCC are variable and conflicting. Therefore, this meta-analysis aimed to identify the significant MRI features for MVI of HCC and to determine their diagnostic value. Methods: Original studies reporting the diagnostic performance of MRI for predicting MVI of HCC were identified in MEDLINE and EMBASE up until January 15, 2020. Study quality was assessed using QUADAS-2. A bivariate random-effects model was used to calculate the meta-analytic pooled diagnostic odds ratio (DOR) and 95% confidence interval (CI) for each MRI feature for diagnosing MVI in HCC. The meta-analytic pooled sensitivity and specificity were calculated for the significant MRI features. Results: Among 235 screened articles, we found 36 studies including 4,274 HCCs. Of the 15 available MRI features, 7 were significantly associated with MVI: larger tumor size (>5 cm) (DOR = 5.2, 95% CI [3.0–9.0]), rim arterial enhancement (4.2, 95% CI [1.7–10.6]), arterial peritumoral enhancement (4.4, 95% CI [2.8–6.9]), peritumoral hypointensity on hepatobiliary phase imaging (HBP) (8.2, 95% CI [4.4–15.2]), nonsmooth tumor margin (3.2, 95% CI [2.2–4.4]), multifocality (7.1, 95% CI [2.6–19.5]), and hypointensity on T1-weighted imaging (T1WI) (4.9, 95% CI [2.5–9.6]). Both peritumoral hypointensity on HBP and multifocality showed very high meta-analytic pooled specificities for diagnosing MVI (91.1% [85.4–94.8%] and 93.3% [74.5–98.5%], respectively). Conclusions: Seven MRI features including larger tumor size, rim arterial enhancement, arterial peritumoral enhancement, peritumoral hypointensity on HBP, nonsmooth margin, multifocality, and hypointensity on T1WI were significant predictors for MVI of HCC. These MRI features predictive of MVI can be useful in the management of HCC.

Most CT/MRI and CEUS LI-RADS major features had independent associations with hepatocellular carcinoma; arterial phase hyperenhancement and washout had the strongest associations whereas, for CT/MR... Background The Liver Imaging Reporting and Data System (LI-RADS) assigns a risk category for hepatocellular carcinoma (HCC) to imaging observations. Establishing the contributions of major features...

When hepatocellular carcinoma is being diagnosed with use of gadoxetic acid–enhanced MRI, extending washout appearance to the transitional phase or hepatobiliary phase (instead of restricting it to the portal venous phase) allows higher sensitivity without a reduction in specificity. Background Current Liver Imaging Reporting and Data System guidelines define the washout appearance of gadoxetic acid–enhanced MRI only during the portal venous phase. Defining washout only during the portal venous phase may lead to lower sensitivity for diagnosis of hepatocellular carcinoma (HCC). Purpose To compare the diagnostic performances of three gadoxetic acid–enhanced MRI criteria fono. that part was correcr HCC according to the phases during which washout appearance was determined. Materials and Methods In this retrospective study, patients with a hepatic nodule detected at US surveillance for HCC from January to December 2012 underwent gadoxetic acid–enhanced MRI. Three diagnostic MRI criteria for HCC were defined according to the phases during which washout appearance was observed, with the presence of arterial phase hyperenhancement and hypointensity noted (a) only during the portal venous phase, with washout confined to the portal venous phase; (b) during the portal venous phase or transitio...