Added value of gadoxetic acid-enhanced hepatobiliary phase MR imaging in the diagnosis of hepatocellular carcinoma

To determine the added value of hepatobiliary phase images in gadoxetic acid-enhanced magnetic resonance (MR) imaging in the evaluation of hepatocellular carcinoma (HCC). Institutional review board approved this retrospective study and waived the informed consent. Fifty-nine patients with 84 HCCs un...

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Veröffentlicht in:Radiology 2010-05, Vol.255 (2), p.459-466
Hauptverfasser: Ahn, Sung Soo, Kim, Myeong-Jin, Lim, Joon Seok, Hong, Hye-Suk, Chung, Yong Eun, Choi, Jin-Young
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container_end_page 466
container_issue 2
container_start_page 459
container_title Radiology
container_volume 255
creator Ahn, Sung Soo
Kim, Myeong-Jin
Lim, Joon Seok
Hong, Hye-Suk
Chung, Yong Eun
Choi, Jin-Young
description To determine the added value of hepatobiliary phase images in gadoxetic acid-enhanced magnetic resonance (MR) imaging in the evaluation of hepatocellular carcinoma (HCC). Institutional review board approved this retrospective study and waived the informed consent. Fifty-nine patients with 84 HCCs underwent gadoxetic acid-enhanced MR examinations that included 20-minute delayed hepatobiliary phase imaging. MR imaging was performed with a 1.5-T system in 19 patients and a 3.0-T system in 40 patients. A total of 113 hepatic nodules were documented for analysis. Three radiologists independently reviewed two sets of MR images: set 1, unenhanced (T1- and T2-weighted) and gadoxetic acid-enhanced dynamic images; set 2, hepatobiliary phase images and unenhanced and gadoxetic acid-enhanced dynamic images. For each observer, the diagnostic accuracy was compared by using the area under the alternative free-response receiver operating characteristic curve (A(z)). Sensitivity and specificity were also calculated and compared between the two sets. For all observers, A(z) values were higher with the addition of the hepatobiliary phase. The observer who had the least experience in abdominal imaging (2 years) demonstrated significant improvement in A(z), from 0.895 in set 1 to 0.951 in set 2 (P = .049). Sensitivity increased with the addition of hepatobiliary phase images but did not reach statistical significance. Nine HCCs (10.7%) in six patients (10.1%) were seen only on hepatobiliary phase images. Hepatobiliary phase images obtained after gadoxetic acid-enhanced dynamic MR imaging may improve diagnosis of HCC and assist in surgical planning.
doi_str_mv 10.1148/radiol.10091388
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Institutional review board approved this retrospective study and waived the informed consent. Fifty-nine patients with 84 HCCs underwent gadoxetic acid-enhanced MR examinations that included 20-minute delayed hepatobiliary phase imaging. MR imaging was performed with a 1.5-T system in 19 patients and a 3.0-T system in 40 patients. A total of 113 hepatic nodules were documented for analysis. Three radiologists independently reviewed two sets of MR images: set 1, unenhanced (T1- and T2-weighted) and gadoxetic acid-enhanced dynamic images; set 2, hepatobiliary phase images and unenhanced and gadoxetic acid-enhanced dynamic images. For each observer, the diagnostic accuracy was compared by using the area under the alternative free-response receiver operating characteristic curve (A(z)). Sensitivity and specificity were also calculated and compared between the two sets. For all observers, A(z) values were higher with the addition of the hepatobiliary phase. The observer who had the least experience in abdominal imaging (2 years) demonstrated significant improvement in A(z), from 0.895 in set 1 to 0.951 in set 2 (P = .049). Sensitivity increased with the addition of hepatobiliary phase images but did not reach statistical significance. Nine HCCs (10.7%) in six patients (10.1%) were seen only on hepatobiliary phase images. 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The observer who had the least experience in abdominal imaging (2 years) demonstrated significant improvement in A(z), from 0.895 in set 1 to 0.951 in set 2 (P = .049). Sensitivity increased with the addition of hepatobiliary phase images but did not reach statistical significance. Nine HCCs (10.7%) in six patients (10.1%) were seen only on hepatobiliary phase images. 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source MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection
subjects Adult
Aged
Carcinoma, Hepatocellular - diagnosis
Contrast Media
Diagnosis, Differential
Female
Gadolinium DTPA
Humans
Image Interpretation, Computer-Assisted
Liver Neoplasms - diagnosis
Magnetic Resonance Imaging - methods
Male
Middle Aged
Retrospective Studies
ROC Curve
Sensitivity and Specificity
title Added value of gadoxetic acid-enhanced hepatobiliary phase MR imaging in the diagnosis of hepatocellular carcinoma
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