Comparison of Diagnostic Efficacy of Gd-EOB-DTPA-Enhanced MRI and Dynamic Contrast-Enhanced Multislice CT in Hepatocellular Carcinoma

[Background]: Hepatocellular carcinoma (HCC) is a common cause of cancer death. In planning optimal treatment, it is important to determine accurately the number and size of HCC lesions. We compared the ability of gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid(Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and dynamic contrast-enhanced computed tomography (CT) to detect HCC lesions in a clinical setting. [Methods]: We retrospectively investigated the medical records of 47 consecutive patients (age 65.4±9.1 years; 74% men) with suspected focal liver lesions detected by ultrasonography, unenhanced CT, or elevated serum α-fetoprotein levels. All patients had undergone both dynamic contrast-enhanced 64-multislice CT and Gd-EOB-DTPA-enhanced MRI. All images were examined by experienced independent radiologists and were compared with a final diagnosis that was based on all available clinical information and was determined via consensus. The McNemar test was used to compare the 2 imaging modalities in lesion-based analysis for the detection of HCC. [Results]: Clinical, histopathologic, and radiologic follow-up revealed 58 HCC lesions in 24 patients. Dynamic contrast-enhanced CT and Gd-EOB-DTPA-enhanced MRI detected 43 and 54 HCC lesions, respectively; 39 lesions were detected by both modalities. The sensitivity was 74% for CT and 93% for MRI (p=0.022). Even when no lesion was detected by dynamic contrast-enhanced CT, Gd-EOB-DTPA-enhanced MRI depicted 15 hypointense lesions during the hepatobiliary phase, with very weak Gd-EOB-DTPA-enhancement during the early arterial phase. Moreover, 1 lesion showed a mixture of hypointensity and hyperintensity during the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI and was histologically diagnosed as a mixture of well-differentiated HCC and so-called green hepatoma. [Conclusions]: The clinical sensitivity of Gd-EOB-DTPA-enhanced MRI was better than that of dynamic contrast-enhanced 64-multislice CT for diagnosis of HCC.