Title: The fate of indeterminate liver lesions: what proportion are precursors of hepatocellular
carcinoma?
Version: 2 Date: 28 Nov 2021
Reviewer's report:
Thank you for this very well-conducted work dealing with a very interesting topic.
I have some observations that I hope you will find constructive.
1) Your definition of "indeterminate liver lesion" is not clear at all. The reader may understand
what you are referring to in clinical practice but I think that in this setting it's important to define
the characteristics of these lesions way better.
In particular
- Some more precise and thorough references may help
- How did you come up with the keywords for your search query? This is a very delicate point
and a strong limitation of your study that largely affects the validity of your results and needs
adequate detail
- A table summarizing the characteristics of all the one hundred and nine patients should be
reported.
2) Line 145-149: This is very confusing. Is survival time referred to mortality or, as you state,  to
"interval between first MRI scan showing an indeterminate lesion and first MRI scan to diagnose
HCC (cases), or date of most recent MRI scan for patients with no HCC during follow up"? Is
mortality reported?  What's the difference between overall survival and HCC-free survival?
In addition, Kaplan-Meier curves should be reported  in the results section.
3) Line 194-199: It is not clear whether initial size is confirmed to be predictive of HCC
transformation. Interpretation of these particular results should not  be part of the results section
but rather of the discussion section. Please be sure to add some sort of clarification on these
data in the discussion.
3) Please be sure to specify all the abbreviations in the text when introduced for the first time.
Title: The fate of indeterminate liver lesions: what proportion are precursors of hepatocellular
carcinoma?
Version: 2 Date: 28 Nov 2021
Reviewer's report:
Thank you for this very well-conducted work dealing with a very interesting topic.
I have some observations that I hope you will find constructive.
1) Your definition of "indeterminate liver lesion" is not clear at all. The reader may understand
what you are referring to in clinical practice but I think that in this setting it's important to define
the characteristics of these lesions way better.
In particular
- Some more precise and thorough references may help
- How did you come up with the keywords for your search query? This is a very delicate point
and a strong limitation of your study that largely affects the validity of your results and needs
adequate detail
- A table summarizing the characteristics of all the one hundred and nine patients should be
reported.
2) Line 145-149: This is very confusing. Is survival time referred to mortality or, as you state,  to
"interval between first MRI scan showing an indeterminate lesion and first MRI scan to diagnose
HCC (cases), or date of most recent MRI scan for patients with no HCC during follow up"? Is
mortality reported?  What's the difference between overall survival and HCC-free survival?
In addition, Kaplan-Meier curves should be reported  in the results section.
3) Line 194-199: It is not clear whether initial size is confirmed to be predictive of HCC
transformation. Interpretation of these particular results should not  be part of the results section
but rather of the discussion section. Please be sure to add some sort of clarification on these
data in the discussion.
3) Please be sure to specify all the abbreviations in the text when introduced for the first time.
Please review this paper.
user
Title: The fate of indeterminate liver lesions: what proportion are precursors of hepatocellular
carcinoma?
Version: 2 Date: 28 Nov 2021
Reviewer's report:
Thank you for this very well-conducted work dealing with a very interesting topic.
I have some observations that I hope you will find constructive.
1) Your definition of "indeterminate liver lesion" is not clear at all. The reader may understand
what you are referring to in clinical practice but I think that in this setting it's important to define
the characteristics of these lesions way better.
In particular
- Some more precise and thorough references may help
- How did you come up with the keywords for your search query? This is a very delicate point
and a strong limitation of your study that largely affects the validity of your results and needs
adequate detail
- A table summarizing the characteristics of all the one hundred and nine patients should be
reported.
2) Line 145-149: This is very confusing. Is survival time referred to mortality or, as you state,  to
"interval between first MRI scan showing an indeterminate lesion and first MRI scan to diagnose
HCC (cases), or date of most recent MRI scan for patients with no HCC during follow up"? Is
mortality reported?  What's the difference between overall survival and HCC-free survival?
In addition, Kaplan-Meier curves should be reported  in the results section.
3) Line 194-199: It is not clear whether initial size is confirmed to be predictive of HCC
transformation. Interpretation of these particular results should not  be part of the results section
but rather of the discussion section. Please be sure to add some sort of clarification on these
data in the discussion.
3) Please be sure to specify all the abbreviations in the text when introduced for the first time.
assistant