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Objectives: To assess second‐line antiretroviral therapy (ART) virological failure and HIV drug resistance‐associated mutations (RAMs), in support of third‐line regimen planning in Asia. Methods: Adults > 18 years of age on second‐line ART for ≥ 6 months were eligible. Cross‐sectional data on HIV viral load (VL) and genotypic resistance testing were collected or testing was conducted between July 2015 and May 2017 at 12 Asia‐Pacific sites. Virological failure (VF) was defined as VL > 1000 copies/mL with a second VL > 1000 copies/mL within 3–6 months. FASTA files were submitted to Stanford University HIV Drug Resistance Database and RAMs were compared against the IAS‐USA 2019 mutations list. VF risk factors were analysed using logistic regression. Results: Of 1378 patients, 74% were male and 70% acquired HIV through heterosexual exposure. At second‐line switch, median [interquartile range (IQR)] age was 37 (32–42) years and median (IQR) CD4 count was 103 (43.5–229.5) cells/µL; 93% received regimens with boosted protease inhibitors (PIs). Median duration on second line was 3 years. Among 101 patients (7%) with VF, CD4 count > 200 cells/µL at switch [odds ratio (OR) = 0.36, 95% confidence interval (CI): 0.17–0.77 vs. CD4 ≤ 50) and HIV exposure through male–male sex (OR = 0.32, 95% CI: 0.17–0.64 vs. heterosexual) or injecting drug use (OR = 0.24, 95% CI: 0.12–0.49) were associated with reduced VF. Of 41 (41%) patients with resistance data, 80% had at least one RAM to nonnucleoside reverse transcriptase inhibitors (NNRTIs), 63% to NRTIs, and 35% to PIs. Of those with PI RAMs, 71% had two or more. Conclusions: There were low proportions with VF and significant RAMs in our cohort, reflecting the durability of current second‐line regimens. [ABSTRACT FROM AUTHOR]

Objectives: Early mortality among those still initiating antiretroviral therapy (ART) with advanced stages of HIV infection in resource‐limited settings remains high despite recommendations for universal HIV treatment. We investigated risk factors associated with early mortality in people living with HIV (PLHIV) starting ART at low CD4 levels in the Asia‐Pacific. Methods: PLHIV enrolled in the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD) who initiated ART with a CD4 count < 100 cells/μL between 2003 and 2018 were included in the study. Early mortality was defined as death within 1 year of ART initiation. PLHIV in follow‐up for > 1 year were censored at 12 months. Competing risk regression was used to analyse risk factors with loss to follow‐up as a competing risk. Results: A total of 1813 PLHIV were included in the study, of whom 74% were male. With 73 (4%) deaths, the overall first‐year mortality rate was 4.27 per 100 person‐years (PY). Thirty‐eight deaths (52%) were AIDS‐related, 10 (14%) were immune reconstituted inflammatory syndrome (IRIS)‐related, 13 (18%) were non‐AIDS‐related and 12 (16%) had an unknown cause. Risk factors included having a body mass index (BMI) < 18.5 [sub‐hazard ratio (SHR) 2.91; 95% confidence interval (CI) 1.60–5.32] compared to BMI 18.5–24.9, and alanine aminotransferase (ALT) ≥ 5 times its upper limit of normal (ULN) (SHR 6.14; 95% CI 1.62–23.20) compared to ALT < 5 times its ULN. A higher CD4 count (51–100 cells/μL: SHR 0.28; 95% CI 0.14–0.55; and > 100 cells/μL: SHR 0.12; 95% CI 0.05–0.26) was associated with reduced hazard for mortality compared to CD4 count ≤ 25 cells/μL. Conclusions: Fifty‐two per cent of early deaths were AIDS‐related. Efforts to initiate ART at CD4 counts > 50 cell/μL are associated with improved short‐term survival rates, even in those with late stages of HIV disease. [ABSTRACT FROM AUTHOR]

Objectives: Diabetes is a growing cause of morbidity and mortality in people living with HIV (PLHIV) receiving antiretroviral therapy (ART). We investigated the association between fasting plasma glucose (FPG) levels and mortality, and factors associated with FPG monitoring rates in Asia. Methods: Patients from the Therapeutics Research, Education, and AIDS Training in Asia (TREAT Asia) HIV Observational Database Low Intensity Transfer (TAHOD‐LITE) cohort were included in the present study if they had initiated ART. Competing risk and Poisson regression were used to analyse the association between FPG and mortality, and assess risk factors for FPG monitoring rates, respectively. FPG was categorized as diabetes (FPG ≥ 7.0 mmol/L), prediabetes (FPG 5.6–6.9 mmol/L) and normal FPG (FPG < 5.6 mmol/L). Results: In total, 33 232 patients were included in the analysis. Throughout follow‐up, 59% had no FPG test available. The incidence rate for diabetes was 13.7 per 1000 person‐years in the 4649 patients with normal FPG at ART initiation. Prediabetes [sub‐hazard ratio (sHR) 1.32; 95% confidence interval (CI) 1.07–1.64] and diabetes (sHR 1.90; 95% CI 1.52–2.38) were associated with mortality compared to those with normal FPG. FPG monitoring increased from 0.34 to 0.78 tests per person‐year from 2012 to 2016 (P < 0.001). Male sex [incidence rate ratio (IRR) 1.08; 95% CI 1.03–1.12], age > 50 years (IRR 1.14; 95% CI 1.09–1.19) compared to ≤ 40 years, and CD4 count ≥ 500 cells/μL (IRR 1.04; 95% CI 1.00–1.09) compared to < 200 cells/μL were associated with increased FPG monitoring. Conclusions: Diabetes and prediabetes were associated with mortality. FPG monitoring increased over time; however, less than half of our cohort had been tested. Greater resources should be allocated to FPG monitoring for early diabetic treatment and intervention and to optimize survival. [ABSTRACT FROM AUTHOR]

Objectives: With earlier antiretroviral therapy (ART) initiation, time spent in HIV care is expected to increase. We aimed to investigate loss to follow‐up (LTFU) in Asian patients who remained in care 5 years after ART initiation. Methods: Long‐term LTFU was defined as LTFU occurring after 5 years on ART. LTFU was defined as (1) patients not seen in the previous 12 months; and (2) patients not seen in the previous 6 months. Factors associated with LTFU were analysed using competing risk regression. Results: Under the 12‐month definition, the LTFU rate was 2.0 per 100 person‐years (PY) [95% confidence interval (CI) 1.8–2.2 among 4889 patients included in the study. LTFU was associated with age > 50 years [sub‐hazard ratio (SHR) 1.64; 95% CI 1.17–2.31] compared with 31–40 years, viral load ≥ 1000 copies/mL (SHR 1.86; 95% CI 1.16–2.97) compared with viral load < 1000 copies/mL, and hepatitis C coinfection (SHR 1.48; 95% CI 1.06–2.05). LTFU was less likely to occur in females, in individuals with higher CD4 counts, in those with self‐reported adherence ≥ 95%, and in those living in high‐income countries. The 6‐month LTFU definition produced an incidence rate of 3.2 per 100 PY (95% CI 2.9–3.4 and had similar associations but with greater risks of LTFU for ART initiation in later years (2006–2009: SHR 2.38; 95% CI 1.93–2.94; and 2010–2011: SHR 4.26; 95% CI 3.17–5.73) compared with 2003–2005. Conclusions: The long‐term LTFU rate in our cohort was low, with older age being associated with LTFU. The increased risk of LTFU with later years of ART initiation in the 6‐month analysis, but not the 12‐month analysis, implies that there was a possible move towards longer HIV clinic scheduling in Asia. [ABSTRACT FROM AUTHOR]

Objectives: With aging of the HIV‐positive population, cardiovascular disease (CVD) increasingly contributes to morbidity and mortality. We investigated CVD‐related and other causes of death (CODs) and factors associated with CVD in a multi‐country Asian HIV‐positive cohort. Methods: Patient data from 2003–2017 were obtained from the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD). We included patients on antiretroviral therapy (ART) with > 1 day of follow‐up. Cumulative incidences were plotted for CVD‐related, AIDS‐related, non‐AIDS‐related, and unknown CODs, and any CVD (i.e. fatal and nonfatal). Competing risk regression was used to assess risk factors of any CVD. Results: Of 8069 patients with a median follow‐up of 7.3 years [interquartile range (IQR) 4.4–10.7 years], 378 patients died [incidence rate (IR) 6.2 per 1000 person‐years (PY)], and this total included 22 CVD‐related deaths (IR 0.36 per 1000 PY). Factors significantly associated with any CVD event (IR 2.2 per 1000 PY) were older age [sub‐hazard ratio (sHR) 2.21; 95% confidence interval (CI) 1.36–3.58 for age 41–50 years; sHR 5.52; 95% CI 3.43–8.91 for ≥ 51 years, compared with < 40 years], high blood pressure (sHR 1.62; 95% CI 1.04–2.52), high total cholesterol (sHR 1.89; 95% CI 1.27–2.82), high triglycerides (sHR 1.55; 95% CI 1.02–2.37) and high body mass index (BMI) (sHR 1.66; 95% CI 1.12–2.46). CVD crude IRs were lower in the later ART initiation period and in lower middle‐ and upper middle‐income countries. Conclusions: The development of fatal and nonfatal CVD events in our cohort was associated with older age, and treatable risk factors such as high blood pressure, triglycerides, total cholesterol and BMI. Lower CVD event rates in middle‐income countries may indicate under‐diagnosis of CVD in Asian‐Pacific resource‐limited settings. [ABSTRACT FROM AUTHOR]

Objectives HIV-associated neurocognitive disorder ( HAND) is an independent predictor of early mortality and is associated with many difficulties in activities of daily living. We sought to determine the prevalence of and risk factors for HAND in HIV-infected Koreans. In addition, we investigated the performance of screening tools and components of neuropsychological ( NP) tests for diagnosing HAND. Methods HIV-infected patients were enrolled consecutively from two different urban teaching hospitals in Seoul, South Korea between March 2012 and September 2012. Participants completed a detailed NP assessment of six cognitive domains commonly affected by HIV. The Frascati criteria were used for diagnosing HAND. Four key questions, the International HIV Dementia Scale ( IHDS) and Montreal Cognitive Assessment ( MoCA)- K were also assessed as potential tools for screening for HAND. Results Among the 194 participants, the prevalence of HAND was 26.3%. Asymptomatic neurocognitive impairment and minor neurocognitive disorder accounted for 52.9 and 47.1% of the patients with HAND, respectively. In multivariate analysis, haemoglobin ( Hb) level ≤ 13 g/dL ( P = 0.046) and current use of a protease inhibitor-based regimen ( P = 0.031) were independent risk factors for HAND. The sensitivity and specificity of the IHDS were 72.6 and 60.8%, and those of MoCA-K were 52.9 and 73.4%, respectively. The IHDS ( P < 0.001) and MoCA-K ( P < 0.001) were both useful for screening for HAND. Among NP tests, the sensitivity and specificity of the Grooved Pegboard Test were 90.2 and 72.0%, and those of the Wisconsin Card Sorting Test were 61.2 and 84.4%, respectively. Conclusions HAND is a prevalent comorbidity in HIV-infected Koreans. Active screening and diagnosis with effective tools, such as the IHDS, MoCA-K and Grooved Pegboard Test, could be used to identify this important complication. [ABSTRACT FROM AUTHOR]

Objectives We evaluated the effect of the time interval between the initiation of antiretroviral therapy ( ART) and the initiation of tuberculosis ( TB) treatment on clinical outcomes in HIV/ TB-coinfected patients in an Asian regional cohort. Methods Adult HIV/ TB-coinfected patients in an observational HIV-infected cohort database who had a known date of ART initiation and a history of TB treatment were eligible for study inclusion. The time interval between the initiation of ART and the initiation of TB treatment was categorized as follows: TB diagnosed while on ART, ART initiated ≤ 90 days after initiation of TB treatment ('early ART'), ART initiated > 90 days after initiation of TB treatment ('delayed ART'), and ART not started. Outcomes were assessed using survival analyses. Results A total of 768 HIV/ TB-coinfected patients were included in this study. The median CD4 T-cell count at TB diagnosis was 100 [interquartile range ( IQR) 40-208] cells/μL. Treatment outcomes were not significantly different between the groups with early ART and delayed ART initiation. Kaplan− Meier analysis indicated that mortality was highest for those diagnosed with TB while on ART (3.77 deaths per 100 person-years), and the prognoses of other groups were not different (in deaths per 100 person-years: 2.12 for early ART, 1.46 for delayed ART, and 2.94 for ART not started). In a multivariate model, the interval between ART initiation and TB therapy initiation did not significantly impact all-cause mortality. Conclusions A negative impact of delayed ART in patients coinfected with TB was not observed in this observational cohort of moderately to severely immunosuppressed patients. The broader impact of earlier ART initiation in actual clinical practice should be monitored more closely. [ABSTRACT FROM AUTHOR]

BACKGROUND: Osteoarthritis is a leading cause of disability. Nonsurgical treatment is a key first step. PURPOSE: Systematic literature review of physical therapy (PT) interventions for community-dwelling adults with knee osteoarthritis. DATA SOURCES: MEDLINE, the Cochrane Library, the Physiotherapy Evidence Database, Scirus, Allied and Complementary Medicine, and the Health and Psychosocial Instruments bibliography database. STUDY SELECTION: 193 randomized, controlled trials (RCTs) published in English from 1970 to 29 February 2012. DATA EXTRACTION: Means of outcomes, PT interventions, and risk of bias were extracted to pool standardized mean differences. Disagreements between reviewers abstracting and checking data were resolved through discussion. DATA SYNTHESIS: Meta-analyses of 84 RCTs provided evidence for 13 PT interventions on pain (58 RCTs), physical function (36 RCTs), and disability (29 RCTs). Meta-analyses provided low-strength evidence that aerobic (11 RCTs) and aquatic (3 RCTs) exercise improved disability and that aerobic exercise (19 RCTs), strengthening exercise (17 RCTs), and ultrasonography (6 RCTs) reduced pain and improved function. Several individual RCTs demonstrated clinically important improvements in pain and disability with aerobic exercise. Other PT interventions demonstrated no sustained benefit. Individual RCTs showed similar benefits with aerobic, aquatic, and strengthening exercise. Adverse events were uncommon and did not deter participants from continuing treatment. LIMITATION: Variability in PT interventions and outcomes measures hampered synthesis of evidence. CONCLUSION: Low-strength evidence suggested that only a few PT interventions were effective. Future studies should compare combined PT interventions (which is how PT is generally administered for pain associated with knee osteoarthritis). PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of variable measurement methods on mean and maximum SUV ratios of 18F-FDG uptake in carotid arteries. Methods: 18F-FDG PET/CT images of 74 subjects with carotid plaque were analyzed for mean and maximum target-to-background ratio (TBR) of uptake. Agreement was analyzed between TBR scores obtained using different vessel coverage and slice skipping. Results: Mean TBR was increased by extending coverage from common carotid artery (CCA; 1.25) to carotid artery (CA; 1.33) and inclusion of ascending aorta (CA/AA; 1.34). Maximum TBR was increased from 1.47 to 1.54 and 1.61 by respective extensions. Both mean and maximum TBR were closely correlated between vessels. ICC and Kappa statistics revealed near perfect agreement between TBR obtained using every 2 or 3 segments and that without sipping. Bland-Altman plots showed bias by slice skipping to remain small, particularly for mean TBR. Finally, high correlations were displayed between mean and maximum TBR. Conclusions: Analysis of mean and maximum arterial 18F-FDG uptake in patients with carotid plaque is likely to benefit from extending coverage to segments above and below the CCA. The extra burden of measurement, in turn, can be lightened by skipping up to every 2 of 3 slices without compromising accuracy of results. [ABSTRACT FROM AUTHOR]

Background: CD151 is a member of the tetraspanin family, which interacts with laminin-binding integrins and other tetraspanins. This protein is implicated in motility, invasion, and metastasis of cancer cells, but the prevalence of CD151 expression in subtypes of breast cancers and its influence on clinical outcome remains to be evaluated.Methods and Results: The immunohistochemistry-based tissue microarray analysis showed that 127 (14.3%) cases overexpressed CD151 among 886 breast cancer patients. CD151 overexpression was found to be significantly associated with larger tumour size, higher nodal stage, advanced stage, absence of oestrogen receptor and progesterone receptor, and human epidermal growth factor receptor 2 overexpression. CD151 overexpression resulted in poorer overall survival (OS) (P<0.001) and disease-free survival (P=0.02), and stage II and III patients with CD151 overexpression demonstrated substantially poorer OS (P=0.0474 and 0.0169). In the five subtypes analyses, CD151 overexpression retained its adverse impact on OS in the Luminal A (P=0.0105) and quintuple-negative breast cancer (QNBC) subtypes, one subgroup of triple-negative breast cancer (P=0.0170). Multivariate analysis that included stage, subtype, and adjuvant chemotherapy showed that CD151 overexpression was independently associated with poor OS in invasive breast cancer.Conclusion: CD151 overexpression may be a potential molecular therapeutic target for breast cancer, especially in QNBC subtype and more advanced stages of breast cancer. [ABSTRACT FROM AUTHOR]

AIM: To compare the diagnostic performances of gadoxetic acid-enhanced magnetic resonance imaging (MRI) and multiphasic multidetector computed tomography (MDCT) in the detection of hepatocellular carcinoma (HCC) in patients with chronic liver disease. MATERIALS AND METHODS: Institutional review board approval was obtained for this study and informed consent was obtained from all patients. Fifty-one patients (43 men, eight women; age range 32-80 years) with 73 HCCs underwent gadoxetic acid-enhanced MRI and multiphasic MDCT. Two readers independently analysed each image in three separate reading sessions. The alternative free-response receiver operating characteristic (AFROC) method was used to analyse the diagnostic accuracy. Positive and negative predictive values and sensitivity were evaluated. RESULTS: A total of 73 HCCs were detected in 51 patients. Although not significant (p>0.05), the areas under the receiver operating characteristic curves were 0.877 and 0.850 for MDCT, 0.918 and 0.911 for dynamic MRI, and 0.905 and 0.918 for combined interpretation of dynamic and hepatobiliary phase MR images. Differences in sensitivity, specificity, and positive and negative predictive values between the readers were not statistically significant (p>0.05). Combined interpretation of dynamic and hepatobiliary phase MRI images was more useful than MDCT in the detection of HCC lesions <=1cm in diameter for one reader (p=0.043). CONCLUSION: Gadoxetic acid-enhanced MRI and MDCT show similar diagnostic performances for the detection of HCC in patients with chronic liver disease. However, the combined interpretation of dynamic and hepatobiliary phase MRI images may improve diagnostic accuracy in the detection of HCC lesions <=1cm in diameter. [ABSTRACT FROM AUTHOR]

Purpose: The burden of serving as a caregiver is known to impair quality of life (QOL) and mental health caregivers of cancer patients. However, few studies focused on the caregivers of terminal cancer patients. Furthermore, none has compared them with those of general population.Methods: We surveyed the family caregivers of terminal cancer patients who received palliative care services in Korea. Control individuals were selected from participants in the first round of the fourth Korea National Health and Nutrition Examination Survey and were matched with family caregivers using the propensity score method to optimize our comparative analysis.Results: Health-related QOL was significantly lower in the caregiver group than in the controls. Caregivers experienced more frequent episodes of depression during the previous year than did controls (36.3% vs. 12.4%, P < 0.0001). Caregiver burden, such as "impact on health," "financial problems," and "lack of family support" had a negative influence on the health-related QOL and mental health. However, "disrupted schedule" had a positive influence on the QOL and mental health.Discussion: Our results show that the family caregivers of patients with terminal cancer experience mental health problems and deterioration of health-related QOL. Culturally appropriate caregiver support programs are needed to decrease the impact of caregiving on the QOL and mental health of family caregivers in Korea. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate the effects of hamstring harvesting in patients after anterior cruciate ligament (ACL) reconstruction by comparing groups with and without hamstring harvesting. Methods: We evaluated the effect of hamstring harvesting in 73 consecutive patients who underwent ACL reconstruction: 39 patients whose hamstrings were harvested for autografts (group H) were compared with 34 patients who received allografts during the same time period (group C [control]). The cases and controls were compared by analyzing the following variables: age, height, weight, mean follow-up period, type of tissue used, and meniscal surgery. Outcomes were assessed by the Lysholm knee score, Tegner activity score, and KT-2000 side-to-side difference (MEDmetric, San Diego, CA), as well as functional performance tests. The flexor deficit and isokinetic peak torque for knee flexion were measured in the sitting position (0° to 90°), and the flexion torque at 90° was measured in the prone position (60° to 120°). Results: Although significant knee flexion weakness after ACL reconstruction was observed, a significantly greater knee flexor deficit was found in autograft patients than in allograft patients (P < .001). No differences were found between groups in terms of clinical and functional results regardless of hamstring harvesting. The performance of both study groups in all 4 functional tests were significantly correlated with flexor deficit in the sitting position (P < .05) but not in hyperflexion. Significant flexor deficits in both normal and hyperflexed positions were noted in both groups when compared with the unaffected knee (group H, P < .001; group C, P = .002). Conclusions: These results indicate significant knee flexion weakness compared with the unaffected knee after ACL reconstruction regardless of hamstring harvesting. Moreover, the greater increase in knee flexor deficit in the hamstring-harvested group compared with the allograft group was statistically significant. However, clinical and functional outcomes were similar between the groups. Level Of Evidence: Level III, case-control study. [ABSTRACT FROM AUTHOR]

Purpose: The Internet becomes one of the most effective communication media in healthcare. This study aimed to evaluate the cancer information sources and the needs of various types of Internet users.Methods: We conducted a survey on the National Cancer Information Center website from April 2007 to December 2007. Of the 170,746 visitors, 507 responded to the survey, and the data were analyzed according to self-identified user types.Results: The participants identified themselves as patients (17%), caregivers (32%), healthcare professionals (21%), or general public (30%). Different user groups looked for different cancer information. Totally, 72.1% patients and 82% caregivers wanted the information about treatment, and 71.3% of healthcare professionals and 88.2% of the general public wanted the information related to 'prevention & diagnosis.' Healthcare professionals had a higher need for "statistics & research" information compared to other Internet user groups. The Internet was reported as the most common source of cancer information for all user groups.Conclusions: The type of cancer information needed and the usefulness of the information acquired on the Internet varied among the different types of user groups, suggesting that Web-based cancer information should be tailored to each type of user. [ABSTRACT FROM AUTHOR]

The purpose of this article is to review the imaging features of thoracic epithelioid hemangioendotheliomas with pathologic correlation. The thoracic manifestation of epithelioid hemangioendotheliomas is one of three different CT patterns: multiple pulmonary nodules, multiple pulmonary reticulonodular opacities, or diffuse infiltrative pleural thickening. Without any evidence of histological malignancy, malignant features (multiplicity of pulmonary nodules, hepatic or bone involvement, lymphangitic tumor spread, and infiltrative pleural masses) are characteristic of these infrequent tumors. [ABSTRACT FROM AUTHOR]

Arteriovenous (AV) shunts are relatively uncommon in the liver and usually associated with advanced hepatocellular carcinoma (HCC). In patients with massive AV shunts complicating advanced HCC, transarterial chemoinfusion therapy is not effective because chemotherapeutic agents go through the shunts and may cause systemic toxicity as well as decrease the chemotherapeutic effects against the tumor. We report two cases of successful transcatheter venous embolization of massive AV shunts complicating advanced HCC using the Amplatzer Vascular Plug for transarterial chemoinfusion therapy. [ABSTRACT FROM AUTHOR]

Objective: To retrospectively assess the value of adding gadolinium-enhanced dynamic imaging to standard ununenhanced magnetic resonance imaging (MRI) for characterising hypoattenuating hepatic lesions that are too small to characterise with multi-detector computed tomography (MDCT).Methods: Informed consent was waved, and institutional review board approval was obtained. Three hundred and forty-six small (≤ 2 cm) lesions (63 metastatic, 283 benign) in 183 patients with underlying carcinoma who underwent hepatic MRI after CT were retrospectively analysed. Two radiologists independently reviewed images and diagnoses were graded on an ordinal scale from 1 (definitely benign) to 5 (definitely malignant). Receiver operating characteristic analysis was used. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were also determined.Results: The areas under the curve of the ununenhanced images alone and with dynamic images were 0.837 and 0.850 for reader 1 (p = 0.616) and 0.771 and 0.783 for reader 2 (p = 0.700). Descriptive statistical values demonstrated sensitivities of 76% and 80%, specificities of 93% and 95%, PPVs of 69% and 79%, NPVs of 95% and 95% and accuracies of 90% and 92%, respectively.Conclusion: The value of adding three-phase contrast-enhanced MRI to unenhanced imaging did not reach statistical significance for characterising small hypoattenuating hepatic lesions on MDCT. [ABSTRACT FROM AUTHOR]