Lower HCC risk in small hypervascular LR-3 nodules without ancillary features

In a retrospective study of 166 hypervascular LI-RADS 3 observations <2 cm without ancillary features, only 3.0% (95% CI 0–6.1%) progressed to HCC at 1 year, far lower than the ~one-third rate often cited for the overall LR-3 category.

• Design: Single-center retrospective cohort of 129 patients with 166 hypervascular LR-3 nodules on MRI (2013–2018).
• Secondary: Overall HCC rate was 6.5% (95% CI 2.2–10.7%); progression was defined by LR-5 upgrade and growth over a median 360 days.
• Limitation: Retrospective, single-institution study with a modest sample size, limiting external validity.

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