Imaging features and prognosis after curative resection of proliferative hepatocellular carcinoma with LR-4/5 and LR-M

Motivation: Proliferative hepatocellular carcinomas (HCC) have higher malignancy and worse prognosis than non-proliferative HCC. The HCCs with the Liver Imaging Reporting and Data System (LI-RADS) v2018 category M (LR-M) also associated with the early occurrence. Goal(s): To investigate the preoperative predictive factors for identifying proliferative HCC based on LI-RADS category 4/5 (LR-4/5) and LR-M, and evaluate their impacts on prognosis. Approach: Retrospective study. Results: Intratumoral artery and non-smooth tumor margin were independent risk factors for proliferative HCC in LR-4/5. Substantial hypoenhancing component was independent risk factor in LR-M. The RFS of non-proliferative and proliferative LR-M groups were worse than other group. Impact: Combining LI-RADS classification and proliferation helps to stratify the risk of recurrence after curative resection in patients with solitary HCC.