ABSTRACT
BACKGROUND/PURPOSE: Hepatocellular carcinoma (HCC) can be noninvasively diagnosed through dynamic computed tomography (CT) and magnetic resonance imaging (MRI). We compared the diagnostic performance of CT and gadoxetic acid-enhanced MRI (EOB-MRI) in categorizing tumors by using the 2018 version of the Liver Imaging Reporting And Data System (LI-RADS v2018) and assessing liver tumors before resection. METHODS: Data from a prospective cohort from October 2011 to March 2019 on 106 hepatic tumors in 96 patients with suspected malignancy were included in this study. We performed preoperative CT and EOB-MRI, and reviewed these images retrospectively. Ninety-seven tumors from 87 patients were pathologically diagnosed as HCC, and nine tumors were non-HCC. The clinical data, imaging characteristics, diagnostic performance, and outcomes of CT and EOB-MRI were analyzed and compared. RESULTS: EOB-MRI had more favorable diagnostic performance (area under curve: 0.920 vs. 0.868) and significantly higher sensitivity (86.87% vs. 69.70%, p = 0.005) than did CT. However, the specificity of EOB-MRI did not differ from that of CT (88.89% vs. 88.89%, p > 0.999). Fourteen (14.5%) patients with pathologically verified HCC had lesions categorized as LI-RADS 4 through CT and as LI-RADS 5 through EOB-MRI. Patients with EOB-MRI-categorized but not CT-categorized LI-RADS 5 lesions had significantly longer overall survival than did those with LI-RADS 4 lesions (p < 0.001). CONCLUSION: EOB-MRI had higher sensitivity than did CT in diagnosing HCC. Patients with EOB-MRI-categorized LI-RADS 5 lesions had more favorable outcomes than did those with LI-RADS 4 lesions after liver resection.
Subject(s)
Carcinoma, Hepatocellular , Gadolinium DTPA , Liver Neoplasms , Humans , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/surgery , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/surgery , Retrospective Studies , Prospective Studies , Contrast Media , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Sensitivity and SpecificityABSTRACT
OBJECTIVE: The objective was to compare vascular and hepatic enhancement differences at magnetic resonance imaging (MRI) between Gd-EOB-DTPA and Gd-DTPA in the same subjects. METHODS: Ten healthy subjects received dynamic contrast-enhanced MRI (DCE-MRI) with Gd-EOB-DTPA and then Gd-DTPA to obtain quantitative parameters at 60 and 100 s, respectively. RESULTS: At 60 s, no difference was noted in DCE-MRI parameters between the two contrast agents. At 100 s, mean transit time (MTT) was higher in Gd-EOB-DTPA than in Gd-DTPA (P=.008). CONCLUSIONS: Gd-EOB-DTPA showed vascular and hepatic enhancement similar to Gd-DTPA within the initial 60 s during the dynamic phase, but showed increased MTT due to hepatocytes uptake at 100 s.
