Fig 4.

46-year-old female with an incidentally detected liver lesion. Axial T2W (a) demonstrates a heterogeneous mildly T2 hyperintense lesion in segment VII (dotted circle in a) with no internal fat on axial T1W opposed-phase (inset). Subtracted Gd-EOB-DTPA-enhanced axial T1W fat-saturated sequences demonstrate arterial enhancement (b), persistent high signal in the delayed phase (c) and retention of contrast in the HPB phase (d). R1 characterized this lesion as FNH before and after assessment of HPB phase. R2 initially classified this lesion as adenoma but reclassified as FNH after assessment of the HPB phase. Confidence in diagnosis decreased from high to moderate certainty for R2 and remained at high certainty for R1