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Fig. 3. —Graph shows estimated probability of hepatic malignancy using presence or absence of arterial phase enhancement and of venous phase washout and serum ${alpha}$ -fetoprotein level. With baseline patient age of 55 years, index lesion size of 4.4 cm, and three lesions, probability of malignancy exceeds 60% regardless of ${alpha}$ -fetoprotein level if arterial phase enhancement and either venous or delayed phase washout are present ( ${square}$ ); it rises to more than 80% if ${alpha}$ -fetoprotein value is greater than 10 ng/mL. In patients with a normal ${alpha}$ -fetoprotein level (<20 ng/mL), probability of malignancy is less than 10% if both arterial phase enhancement and venous phase washout are absent ( ${diamond}$ ). In average patient with either arterial enhancement and no venous washout ( ${Delta}$ ) or no arterial enhancement and venous washout ( ${circ}$ ), but not both, contribution of ${alpha}$ -fetoprotein level to estimation of malignancy is increased.

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