Related Experiment Video
Updated: Jan 15, 2026
Non-Invasive PET/MR Imaging in an Orthotopic Mouse Model of Hepatocellular Carcinoma
Published on: August 31, 2022
Enhanced diagnostic performance for subcentimeter hepatocellular carcinoma using a novel criterion integrating serum
Xuying Chen1,2, Haoran Dai1, Jing Liu3
1Department of Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Xuhui District, Shanghai, 200032, China.
Purpose:
To assess the effectiveness of LI-RADS v2018 and r-LI-RADS in diagnosing subcentimeter hepatocellular carcinoma (HCC) and to evaluate the potential value of serum alpha-fetoprotein (AFP) in conjunction with gadolinium-based contrast-enhanced MRI (CE-MRI) for assessing these lesions.
Methods:
This retrospective study included 179 untreated, high-risk patients with microlesions (< 1 cm) from 2015 to 2023. Of these, 92 lesions were pathologically confirmed as HCC, the remaining 87 were non-HCC. Two radiologists independently rated imaging features using LI-RADS and r-LI-RADS. The optimal AFP threshold for HCC diagnosis was determined by the Youden index. Logistic regression analyses identified independent predictors of micro-HCC, leading to the development of new diagnostic criteria.
Results:
Multivariate analysis identified AFP > 12.15 ng/mL, non-peripheral arterial phase enhancement, diffusion restriction, fat deposition, and enhancing capsule as key independent factors for diagnosing micro-HCC. A new criterion requiring at least three positive factors improved sensitivity to 78.3% vs. 58.7% for LR-4 (p = 0.001), with similar specificity (83.9% vs. 81.6%, p = 0.824). It also outperformed r-LR-5/4 and r-LR-4 in sensitivity (78.3% vs. 59.8% and 58.7%, both p = 0.001), without impacting specificity.
Conclusion:
A new criterion (at least three positive findings among AFP > 12.15 ng/mL, non-peripheral arterial phase enhancement, diffusion restriction, fat deposition, and enhancing capsule) significantly improves the diagnostic sensitivity for subcentimeter HCC while maintaining high specificity, demonstrating clear advantages over the LR-4, r-LR-5/4, and r-LR-4 standards of LI-RADS.
