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Page 6 of 9 Shimizu et al. Hepatoma Res 2020;6:12 I http://dx.doi.org/10.20517/2394-5079.2019.48

Figure 2. Kaplan-Meier analysis of overall survival and progression-free survival. DAA: direct-acting antiviral; SVR: sustained viral
response; HCV: hepatitis C virus

in our study, HCC with high intensity on DWI or T2WI was more likely to have moderately or poorly
differentiated HCC compared to well-differentiated HCC. Taken together, these results suggest that high
intensity on DWI or T2WI, the characteristic feature of HCC that developed early after the eradication of
HCV by DAA therapy, may be the hallmark of the possible malignant phenotype of HCC in general.

Despite having these imaging features of malignant potential, the prognosis of HCC after DAA treatment
was comparable to HCV-positive HCC that received curative RFA therapy in terms of OS or PFS. The
possible reason for this fair prognosis is that all DAA-SVR HCC was found in the early stage (mean
diameter of 18 mm and 81% as single nodule), and actually 25 of 26 patients received curative therapy
(resection or RFA in 23 patients and transcatheter arterial chemoembolization with curative consent in 2
patients). However, if these patients were found in a more advanced stage, the prognosis may have been
[21]
worse due to rapid progression or by the inability to receive curative therapy. Mariño et al. recently