Magnetic resonance imaging-based risk factors of hepatocellular carcinoma after direct-acting antiviral therapy: multicenter observational study

A multicenter study3 identified the risk factors associated with HCC development after sustained virologic response (SVR) following direct-acting antiviral (DAA) therapy for HCV. This study included 482 patients with chronic HCV infection, who achieved SVR at post-treatment week 12 (SVR12) and underwent Gd-EOB-DTPA MRI to confirm HCC absence at enrollment. All participants were periodically followed up and Gd-EOB-DTPA MRI was performed every six months. Analysis revealed that the incidence of HCC development was significantly higher in patients with a history of HCC and the presence of HBP hypointense nodules without APHE (Fig. 1). Additionally, the incidence of hypervascular HCC was significantly higher in patients with HBP hypointense nodules lacking APHE but demonstrating hyperintensity on T2-weighted image (T2WI) and/or diffusion-weighted image (DWI) (Fig. 2). These results suggest the need for a more intense monitoring after DAA therapy in patients with HBP hypointense nodules without APHE.