Chung JW, et al. - Researchers sought to verify the utility of subtraction images acquired from gadoxetic acid-enhanced MRI for observation of washout and enhancing capsule in the diagnosis of hepatocellular carcinoma (HCC). Two independent observers determined the presence of washout and enhancing capsule in the portal venous phase (PVP) on conventional MR images with and without corresponding subtraction images for 120 histologically confirmed HCCs in 115 high-risk patients. For various subgroups categorized based on lesion size (< 10 mm, 10–19 mm, ≥ 20 mm), unenhanced T1-weighted signal intensity, and arterial phase hyperenhancement of the lesions, they analyzed the incremental utility of subtraction imaging in upgrading the classes described in the Liver Imaging Reporting and Data System (LI-RADS) version 2018 for the diagnosis of HCC. Findings revealed the superior ability of PVP subtraction imaging during gadoxetic acid–enhanced MRI in depicting enhancing capsule as well as its incremental benefit for demonstrating washout, and therefore, its capability to upgrade LI-RADS categories for the diagnosis of HCC.