Moderate-to-Severe Liver Iron Overload Alters LI-RADS MRI Features and Downgrades HCC Categorization

In retrospective study of 167 HCC lesions on MRI, moderate-to-severe hepatic iron overload independently reduced LR-5 assignment (OR 0.08, 95% CI 0.02–0.28) and altered key LI-RADS features: washout and capsule.

• Retrospective, 163 patients/167 lesions, grouped by R2*: non-iron overload (80 lesions), mild (54), moderate-to-severe (33).
• Moderate-to-severe overload increased T1 iso-/hyperintensity (OR 14.38, 95% CI 4.08–50.70) but reduced nonperipheral washout (OR 0.14) and enhancing capsule (OR 0.15).
• Limitation: Retrospective, single-center design; external validation needed.

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