Deep learning-assisted differentiation of pathologically proven atypical and typical hepatocellular carcinoma (HCC) versus non-HCC on contrast-enhanced MRI of the liver.

Objectives: To train a deep learning model to differentiate between pathologically proven hepatocellular carcinoma (HCC) and non-HCC lesions including lesions with atypical imaging features on MRI.

Methods: This IRB-approved retrospective study included 118 patients with 150 lesions (93 (62%) HCC and 57 (38%) non-HCC) pathologically confirmed through biopsies (n = 72), resections (n = 29), liver transplants (n = 46), and autopsies (n = 3). Forty-seven percent of HCC lesions showed atypical imaging features (not meeting Liver Imaging Reporting and Data System [LI-RADS] criteria for definitive HCC/LR5).