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Subtypes were assigned by two pathologists. Gd-EOB-enhanced MRI datasets were assessed by two radiologists for qualitative and quantitative imaging features, including imaging features defined in LI-RADS v2018 and area of hepatobiliary phase (HBP) iso- to hyperintensity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The combination of non-rim arterial phase hyperenhancement with non-peripheral portal venous washout was more common in \u201cnot otherwise specified\u201d (nos-ST) (88\/168, 52%) than other subtypes, in particular macrotrabecular massive (mt-ST) (3\/15, 20%), chromophobe (ch-ST) (1\/8, 13%), and scirrhous subtypes (sc-ST) (2\/9, 22%) (<jats:italic>p<\/jats:italic>\u2009=\u20090.035). Macrovascular invasion was associated with mt-ST (5\/16, <jats:italic>p<\/jats:italic>\u2009=\u20090.033) and intralesional steatosis with steatohepatitic subtype (sh-ST) (28\/32, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Predominant iso- to hyperintensity in the HBP was only present in nos-ST (16\/174), sh-ST (3\/33), and clear cell subtypes (cc-ST) (3\/13) (<jats:italic>p<\/jats:italic>\u2009=\u20090.031). Associations were found for the following non-imaging parameters: age and sex, as patients with fibrolamellar subtype (fib-ST) were younger (median 44\u00a0years (19\u201366), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and female (4\/5, <jats:italic>p<\/jats:italic>\u2009=\u20090.023); logarithm of alpha-fetoprotein (AFP) was elevated in the mt-ST (median 397\u00a0\u00b5g\/l (74\u20135370), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); type II diabetes mellitus was more frequent in the sh-ST (20\/33, <jats:italic>p<\/jats:italic>\u2009=\u20090.027).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Gd-EOB-MRI reproduces findings reported in the literature for extracellular contrast-enhanced MRI and CT and may be a valuable tool for noninvasive HCC subtype differentiation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical relevance statement<\/jats:title>\n                <jats:p>Better characterization of the heterogeneous phenotypes of HCC\u00a0according to the revised WHO classification potentially improves both diagnostic accuracy and the precision of therapeutic stratification for HCC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:italic>\u2022 Previously reported imaging features of common subtypes in CT and MRI enhanced with extracellular contrast agents are reproducible with Gd-EOB-enhanced MRI.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 While uncommon, predominant iso- to hyperintensity in the HBP was observed only in NOS, clear cell, and steatohepatitic subtypes.<\/jats:italic><\/jats:p>\n                <jats:p><jats:italic>\u2022 Gd-EOB-enhanced MRI offers imaging features that are of value for HCC subtype differentiation according to the 5<\/jats:italic><jats:sup><jats:italic>th<\/jats:italic><\/jats:sup><jats:italic> edition of the WHO Classification of Digestive System Tumors.<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-023-09669-y","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T07:02:33Z","timestamp":1682665353000},"page":"6902-6915","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Gd-EOB MRI for HCC subtype differentiation in a western population according to the 5th edition of the World Health Organization classification"],"prefix":"10.1007","volume":"33","author":[{"given":"Timo A.","family":"Auer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Halskov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uli","family":"Fehrenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora F.","family":"Nevermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Pelzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Mohr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Hamm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzel","family":"Sch\u00f6ning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Horst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Ihlow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Geisel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,28]]},"reference":[{"key":"9669_CR1","doi-asserted-by":"crossref","unstructured":"Llovet JM, Zucman-Rossi J, Pikarsky E et al (2016) Hepatocellular carcinoma. 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All of the other authors who took part in this study declared that they do not have anything to disclose regarding funding or conflict of interest with respect to this manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was obtained from all subjects (patients) in this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"\u2022 retrospective\u2022 diagnostic or prognostic study\u2022 performed at one institution","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}