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Authors
Zhou, Jinhui
Ouyang, Siyu
Chen, Haimei
Zhang, Dingyue
Wang, Yan
Xiao, Yuanqiang
Zeng, Ying
Fang, Zebin
Wang, Yufeng
Chen, Lichun
Zhang, Jing
Zhang, Tianhui
Zhong, Xi
Yang, Qiqi
Bu, XinXin
Yang, Yang
Wang, Jin https://orcid.org/0000-0002-6424-8254
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Funding
Funding for this research was provided by:
National Natural Science Foundation of China grant (82271973)
National Natural Science Foundation of China grant (91959118)
Guangzhou Municipal Research Collaborative Innovation Projects (2024A03J0283)
The ‘Five Five’ Project of the Third Affiliated Hospital of Sun Yat-sen University (2023WW103)
Guangzhou Municipal Health Commission Clinical Speciality Technology (2023P-TS47)
Klarmaj City Science and Technology Program (2025BA0062)
Basic and Applied Basic Research Foundation of Guangdong Province (2021A1515010582)
Key Research and Development Program of Guangdong Province (2019B020235002)
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Article History
Received: 14 July 2025
Revised: 21 December 2025
Accepted: 12 January 2026
First Online: 20 February 2026
Compliance with ethical standards
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: The scientific guarantor of this publication is Jin Wang.
: The authors of this manuscript declare no relationship with any companies.
: Univariable and multivariable logistic regression analyses were performed with a generalized estimating equation model based on a binomial distribution with a logit link function and an independent correlation matrix. The diagnostic performance of each guideline was evaluated via generalized estimating equations to adjust for the correlation between multiple nodules within a patient (clustering effect), and the exact binomial 95% confidence intervals (CIs) were calculated.
: Written informed consent was not required for this study because this study was based on retrospective data and was waived by the Institutional Review Board.
: This retrospective study was reviewed and approved by the third affiliated hospital of Sun Yat-sen University local institutional review boards, approval number [2019]02-455-01.
: A total of 775 of the 1414 patients enrolled in this study were previously included in a previous study (Zhou J et al [ ]). Unlike the previous study, which evaluated modified LI-RADS v2018 based on major features for diagnosing small HCC on ECA-MRI, the present study evaluated the LI-RADS AFs and biomarker to improve the sensitivity of Western and Eastern guidelines for diagnosing HCCs ≤ 30 mm on both ECA-MRI and EOB-MRI.
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