Table 1.

Discrepancy in diagnostic criteria and performance for HCC using HBA-MRI between Western and Asian societies

	Western societies		Asian societies
	AASLD/LI-RADS 2018	EASL 2018	APASL 2017	KLCA-NCC 2018
Diagnostic criteria for definite HCC	1. For observation ≥ 20 mm: 1) APHE plus, 2) one or more additional major features*	APHE plus, washout at PVP	APHE plus, venous washout OR HBP hypointensity (excluding hemangioma)	APHE plus, washout at PVP, DP or HBP (excluding marked T2 hyperintense OR targetoid lesion)
	2. For observation between 10–19 mm: 1) APHE plus, 2) two or more additional major features* OR nonperipheral “washout” OR threshold growth
Definite diagnosis using APHE and HBP hypointensity	Impossible	Impossible	Possible	Possible
Sensitivity	Relatively low	Relatively low	High†	High†
Jeon et al. [13]	34.5	38.8	75.9	65.5
Clarke et al. [14]	45	44	64	N/A
Hwang et al. [15]	60–65	54	91–93	85
Park et al. [16]	67.7–74.2	65.2–71.0	89.4–90.6	82.3–86.1
Specificity	High	High	Relatively low†	Relatively low†
Jeon et al. [13]	97.4	92.1	78.9	92.1
Clarke et al. [14]	89	86	81	N/A
Hwang et al. [15]	92–95	91–94	73–78	85–88
Park et al. [16]	92.7–94.2	89.4–90.6	81.0–83.9	86.9–88.3

HCC, hepatocellular carcinoma; HBA, hepatobiliary contrast agent; MRI, magnetic resonance imaging; AASLD, American Association for the Study of Liver Diseases; LI-RADS, Liver Imaging Reporting and Data System; EASL, the European Association for the Study of the Liver; APASL, the Asian Pacific Association for the Study of the Liver; KLCA-NCC, Korean Liver Cancer Association-National Cancer Center; APHE, arterial phase hyperenhancement; PVP, portal venous phase; HBP, hepatobiliary phase; DP, delayed phase; N/A, not applicable.

^*Additional major features include enhancing “capsule”, nonperipheral “washout”, and threshold growth (≥50% in ≤6 months).

^†APASL criteria shows higher sensitivity but lower specificity than KLCA-NCC criteria since APASL does not exclude targetoid lesion unlike KLCA-NCC.