Does intra-tumoural fat on MRI predict visibility of small (≤3 cm) hepatocellular carcinomas during ultrasound-guided tumour ablation?

•With regular screening of patients with risk factors for hepatocellular carcinoma (HCC), the size of tumour referred for percutaneous ablation becomes smaller. This study aims to study the factors that affect ultrasonographic (US) visibility of HCC to improve patient selection and procedural efficacy.•Intra-tumoural fat on magnetic resonance imaging (MRI) was seen in 23 tumours (23/90, 25.6%) and all (23/23, 100%) were visible on planning US.•The presence of intra-tumoural fat (p=0.005) and distance from diaphragm (p=0.007) were found to be statistically significant factors affecting tumor visibility on planning US.•The presence of intra-tumoural fat in small hepatocellular carcinomas on pre-procedural MRI can predict visibility on planning US for percutaneous ablation.