Hepatobiliary phase hypointense nodule without arterial phase hyperenhancement: are they at risk of HCC recurrence after ablation or surgery? A systematic review and meta-analysis.

• HBP hypointense nodules without APHE constitute an entity that is unique in gadoxetic acid-enhanced MRI. • HBP hypointense nodules without APHE are risk factors for IDR in HCC patients treated with either RFA or hepatectomy. • Stratification of management and modification of proper follow-up strategies may be required in HCC patients who have these nodules on pretreatment gadoxetic acid-enhanced MRI.