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Although some characteristic imaging findings have been described in both hepatoblastoma and HCC, it is difficult to distinguish between these two tumors over the 5 years of age.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>To investigate clinical and radiological findings that may help differentiate hepatoblastoma and HCC over 5 years of age.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>From 2007 to 2022, 19 consecutive patients older than 5 years old diagnosed with primary liver malignancy were yielded from our radiology archive retrospectively. Imaging features, age, sex, treatment, and follow-up data were recorded.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 19 patients (16 boys; median age 7.5, min-max 5-17), ten HCCs and nine hepatoblastomas, were included. Serum alpha-fetoprotein (sAFP) values were significantly higher in hepatoblastoma patients (<jats:italic>n<\/jats:italic>=9), compared to the HCC (<jats:italic>n<\/jats:italic>=10) (<jats:italic>P<\/jats:italic>=0.002). Tumor size and PRETEXT stages were higher in hepatoblastoma patients; however, there was no statistical difference (<jats:italic>P<\/jats:italic>=0.06). Initial MRI was available for six patients with hepatoblastoma and seven patients with HCC, and there was no difference regarding ADCmin values.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>In the differential diagnosis of primary malignant liver tumor in a child older than 5 years of age, higher sAFP level may support the diagnosis of hepatoblastoma rather than HCC.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00247-025-06190-w","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:58:38Z","timestamp":1739840318000},"page":"946-954","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Radiological and clinical signatures to differentiate hepatocellular carcinoma from hepatoblastoma in children older than 5 years of age: a feasibility study"],"prefix":"10.1007","volume":"55","author":[{"given":"Gozde","family":"Ozer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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