Fig. 1.

Differentiation between Eastern and Western guidelines in timing of assessment after gadoxetic acid administration. A pathology-proven HCC in a 46-year-old male patient with chronic hepatitis B. On gadoxetic acid–enhanced MRI, a nodular lesion (arrow) with non-rim APHE is seen in hepatic segment 2 (A) without washout on the PVP (B), with hypointensity on the TP (C) and HBP (D), hyperintensity on high b-value (b = 800) DWI (E). Gross pathology (F) shows a well-defined, yellow tumor, confirmed as HCC. This observation does not meet the criteria for definite HCC using LiRADS or EASL criteria, while it was diagnosed as definite HCC using Asian guidelines such as APASL or KLCA-NCC guidelines. Abbreviations: APASL, Asia-Pacific Association for the Study of the Liver; APHE, arterial phase hyperenhancement; DWI, diffusion-weighted imaging; EASL, European Association for the Study of the Liver; HBP, hepatobiliary phase; HCC, hepatocellular carcinoma; KLCA-NCC, Korean Liver Cancer Association-National Cancer Center Korea; LiRADS, Liver Imaging Reporting and Data System; MRI, magnetic resonance imaging; PVP, portal venous phase; TP, transitional phase. Courtesy Jeong Min Lee