Triphasic MRI evaluation of Hepatocellular Carcinoma according to ACR LI-RADS Compared with Histopathological Reports

This study aims to evaluate the diagnostic accuracy of ACR LI-RADS 5 on Triphasic MRI for detecting hepatocellular carcinoma, using histopathology as the reference standard. This cross-sectional analytical study was conducted in the Department of Radiology and Imaging, Bangladesh Medical University (BMU), Dhaka, Bangladesh from April 2024 to September 2025. Patients with clinical, biochemical, or imaging suspicion of HCC underwent triphasic MRI and were categorized according to the ACR LI-RADS classification system. MRI findings were compared with histopathological diagnoses. Data were analyzed using SPSS version 26.0 and statistical significance was considered at p<0.05. ACR LI-RADS 5 on triphasic MRI demonstrated a sensitivity of 83.33%, specificity of 91.67%, positive predictive value of 93.75%, negative predictive value of 78.57% and overall diagnostic accuracy of 86.67% for the detection of hepatocellular carcinoma. Triphasic MRI showed high diagnostic accuracy, specificity and positive predictive value of ACR LI-RADS 5 for detecting hepatocellular carcinoma, demonstrating strong agreement with histopathological findings and supporting its role as a reliable non-invasive diagnostic tool.