Which imaging pattern favors regenerative nodules over HCC on contrast-enhanced imaging?

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Dynamic contrast-enhanced imaging relies on vascular patterns to tell benign regenerative nodules from hepatocellular carcinoma. Regenerative nodules typically mimic the surrounding liver in all phases, showing no arterial hypervascularity and no washout; they are usually iso- or hypoenhancing relative to the liver and maintain that appearance through the portal and delayed phases. In contrast, hepatocellular carcinoma often has increased arterial blood supply, leading to arterial phase hyperenhancement followed by washout in the portal or delayed phases.

So the pattern without washout and with iso- or hypoenhancement across phases best favors regenerative nodules. Peripheral rim enhancement, or arterial hyperenhancement with subsequent washout, would raise concern for other processes or HCC rather than benign regenerative nodules.