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Comparison of hepatic MDCT, MRI, and DSA to explant pathology for the detection and treatment planning of hepatocellular carcinoma
Clinical and Molecular Hepatology ; : 450-457, 2016.
Article in English | WPRIM | ID: wpr-215521
ABSTRACT
BACKGROUND/

AIMS:

The diagnosis and treatment plan for hepatocellular carcinoma (HCC) can be made from radiologic imaging. However, lesion detection may vary depending on the imaging modality. This study aims to evaluate the sensitivities of hepatic multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA) in the detection of HCC and the consequent management impact on potential liver transplant patients.

METHODS:

One hundred and sixteen HCC lesions were analyzed in 41 patients who received an orthotopic liver transplant (OLT). All of the patients underwent pretransplantation hepatic DSA, MDCT, and/or MRI. The imaging results were independently reviewed retrospectively in a blinded fashion by two interventional and two abdominal radiologists. The liver explant pathology was used as the gold standard for assessing each imaging modality.

RESULTS:

The sensitivity for overall HCC detection was higher for cross-sectional imaging using MRI (51.5%, 95% confidence interval [CI]=36.2-58.4%) and MDCT (49.8%, 95% CI=43.7-55.9%) than for DSA (41.7%, 95% CI=36.2-47.3%) (P=0.05). The difference in false-positive rate was not statistically significant between MRI (22%), MDCT (29%), and DSA (29%) (P=0.67). The sensitivity was significantly higher for detecting right lobe lesions than left lobe lesions for all modalities (MRI 56.1% vs. 43.1%, MDCT 55.0% vs. 42.0%, and DSA 46.9% vs. 33.9%; all P<0.01). The sensitivities of the three imaging modalities were also higher for lesions ≥2 cm vs. <2 cm (MRI 73.4% vs. 32.7%, MDCT 66.9% vs. 33.8%, and DSA 62.2% vs. 24.1%; all P<0.01). The interobserver correlation was rated as very good to excellent.

CONCLUSIONS:

The sensitivity for detecting HCC is higher for MRI and MDCT than for DSA, and so cross-sectional imaging modalities should be used to evaluate OLT candidacy.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Magnetic Resonance Imaging / Tomography, X-Ray Computed / Angiography, Digital Subtraction / Retrospective Studies / Sensitivity and Specificity / Liver Transplantation / Carcinoma, Hepatocellular / Liver Neoplasms Type of study: Diagnostic study / Observational study Limits: Adult / Aged / Female / Humans / Male Language: English Journal: Clinical and Molecular Hepatology Year: 2016 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Magnetic Resonance Imaging / Tomography, X-Ray Computed / Angiography, Digital Subtraction / Retrospective Studies / Sensitivity and Specificity / Liver Transplantation / Carcinoma, Hepatocellular / Liver Neoplasms Type of study: Diagnostic study / Observational study Limits: Adult / Aged / Female / Humans / Male Language: English Journal: Clinical and Molecular Hepatology Year: 2016 Type: Article