AIM:To evaluate the efficacy of ethoxibenzyl-magnetic resonance imaging(EOB-MRI)as a predictor of hepatocellular carcinoma(HCC)development.METHODS:Between August 2008 and 2009,we studied 142 hepatitis C virus-infected patients(male70,female 72),excluding those with HCC or a past history,who underwent EOB-MRI in our hospital.The EOB-MRI index[liver-intervertebral disc ratio(LI)]was calculated as:(post-liver intensity/post-intervertebral disc intensity)/(pre-liver intensity/pre-intervertebral disc intensity).RESULTS:The median follow-up period was 3.1 years and the patients were observed until the end of the study period(31 December,2012).In the follow-up period,HCC occurred in 21 patients.The cumulative occurrence rates were 2.1%,9.1%,and 14.1%at 1,2,and 3 years,respectively.Using the optimal cut-off value of LI 1.46,on univariate analysis,age,aspartate amino transferase(AST),α-fetoprotein(AFP)≥10,albumin,total cholesterol,prothrombin time,platelets,and LI<1.46 were identified as independent factors,but on multivariate analysis,LI<1.46:risk ratio 6.05(1.34-27.3,P=0.019)and AFP≥10:risk ratio 3.1(1.03-9.35,P=0.045)were identified as independent risk factors.LI and Fib-4 index have higher area under the receiver operating characteristic curves than other representative fibrosis evaluation methods,such as Forn’s index and AST-to-platelet ratio index.CONCLUSION:LI is associated with the risk of HCC occurrence in hepatitis C patients.LI may be a substitute for liver biopsy when evaluating this risk and its combined use with Fib-4 is a better predictive method of HCC progression. AIM: To evaluate the efficacy of ethoxibenzyl-magnetic resonance imaging (EOB-MRI) as a predictor of hepatocellular carcinoma (HCC) development. METHODS: Between August 2008 and 2009, we studied 142 hepatitis C virus-infected patients ), excluding those with HCC or a past history, who underwent EOB-MRI in our hospital. The EOB-MRI index [liver-intervertebral disc ratio (LI)] was calculated as: (post-liver intensity / post-intervertebral disc intensity ) / (pre-liver intensity / pre-intervertebral disc intensity) .RESULTS: The median follow-up period was 3.1 years and the patients were observed until the end of the study period (31 December, 2012) .In the follow-up period, HCC occurred in 21 patients. The cumulative incidence rates were 2.1%, 9.1%, and 14.1% at 1, 2, and 3 years, respectively. Using the optimal cut-off value of LI 1.46, on univariate analysis, age, aspartate amino transferase (AST), α-fetoprotein (AFP) ≥10, albumin, total cholesterol, prothrombin time, platelets, and LI <1.46 were identified as ind LI <1.46: risk ratio 6.05 (1.34-27.3, P = 0.019) and AFP≥10: risk ratio 3.1 (1.03-9.35, P = 0.045) were identified as independent risk factors. LI and Fib-4 index have higher area under the receiver operating characteristic curves than other representative fibrosis evaluation methods such as Forn’s index and AST-to-platelet ratio index. CONCLUSION: LI is associated with the risk of HCC occurrence in hepatitis C patients. LI may be a substitute for liver biopsy when evaluating this risk and its combined use with Fib-4 is a better predictive method of HCC progression.