Impact of the updated KLCA-NCC criteria for diagnosis of “probable HCC” in liver MRI: comparisons between KLCA v2022 and v2018

Performance of HCC diagnosis in the KLCA-NCC guidelines: a closer look at MRI contrast agents and HCC imaging hallmarks

“…Subsequently, we are slightly concerned about the interpretation of HCC hallmark visualization based on MRI contrast agents because the details of the imaging features are missing. As highlighted in the editorial by Yoon, 6 the similar diagnostic performance of the ver. 2018 and ver.…”

“…The observation of APHE, no washout, and ancillary features favoring malignancy in general may include other HCC mimickers, such as inflammatory lesions or other tumors like combined hepatocellular cholangiocarcinoma, angiomyolipoma, and neuroendocrine tumors. Further, in Yoon’s study, 6 non-surgical candidates were excluded from the final cohort, thus enriching the cohort for HCC. Although there was no significant sacrifice in specificity with ver.…”

“…2022 between the two contrast agents used in the two patient cohorts might imply an introduced potential bias in Yoon’s study. 6 This issue should be re-evaluated because the motivation of revised version 2020 is not to increase probable HCC categorization with ECA-MRI but not with HBA-MRI. Therefore, caution should be exercised when applying probable HCC in ver.…”