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Garg et al. Hepatoma Res 2019;5:39 I http://dx.doi.org/10.20517/2394-5079.2019.009 Page 9 of 11

contributed to the changes in the liver parenchyma. However we minimized this variation as most of the
studies had histological evaluation within 6 months of CT study.

In conclusion, NAFLD associated HCC may not show portal venous phase washout on CT and may
impact the imaging diagnosis of HCC. Our study should be confirmed in studies with larger population
of NAFLD associated HCCs. There may be a need for modification of criteria for multiphase CT based
diagnosis of NAFLD associated HCCs particularly in the non-cirrhotic patients.

DECLARATIONS
Authors’ contributions
Made substantial contributions to conception and design of the study and performed data analysis and
interpretation: Garg I, Thompson SM, Mounajjed T, Ehman EC, Venkatesh SK
Performed data acquisition, as well as provided administrative, technical, and material support: Garg I,
Thompson SM, Sheedy SP, Mounajjed T, Khandelwal A, Ehman EC, Bookwalter CA, Venkatesh SK

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
In this IRB approved (ID: 15-004925), HIPPA-compliant retrospective study. Written informed consent
waived by the IRB.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2019.

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