LI-RADS v2018 vs KLCA-NCC v2022: HCC probability categories not interchangeable across modalities

On MRI, LI-RADS LR-5 had higher PPV for HCC than KLCA-NCC definite HCC (93.9% vs 91.7%, p<0.001); on CT, PPVs were equal (92.9%). Corresponding probability categories should not be used interchangeably.

• Retrospective multicenter study: 2,237 patients with 2,445 MRI lesions; 1,455 patients with 1,590 CT lesions.
• On CT, KLCA-NCC 'probable HCC' had higher PPV than LR-4 (83.8% vs 73.9%, p=0.012).
• Retrospective design; no prospective external validation.

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