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Because the diagnosis and treatment of hepatocellular carcinoma (HCC) are largely determined with imaging, it is essential that imaging findings in patients who are at risk for HCC are reported clearly and consistently with standardized reports based on the Liver Imaging Reporting and Data System (LI-RADS).

Abbreviated MRI shows promise as a screening study for hepatocellular carcinoma (HCC) surveillance in adults with cirrhosis or chronic hepatitis B virus infection and may facilitate effective treatment and prolongation of life in patients with HCC.

In this multicenter study of interrater agreement on hepatocellular carcinoma imaging diagnosis using a preselected data set of annotated liver examinations, overall agreement was good for final Liver Imaging Reporting and Data System categorization and was high for major feature characterization, with minimal reader demographic effect.

Gadoxetic acid–enhanced 3-T MR imaging provides low per-lesion sensitivity (0% [0 of 26 lesions] to 12% [three of 26 lesions]) for 0.2–0.5 cm, modest per-lesion sensitivity (28% [nine of 32 lesions] to 69% [22 of 32 lesions]) for 0.6–1.0-cm, and high per-lesion sensitivity (81% [13 of 16 lesions] to 100% [20 of 20 lesions]) for at least 1.0-cm malignant lesions in hepatectomy candidates.