Use of gadobenate dimeglumine dynamic MRI for detection of early hepatocellular carcinoma in atypical hepatic focal lesions

Aim: Gadobenate dimeglumine (multihance) is a contrast medium which can be used not only as an extracellular contrast agent for dynamic imaging of the liver, but also as a liver specific agent for the acquisition of hepatobiliary-phase images which are more helpful in evaluation of small atypical hepatic focal lesions equal or less than 3 cm. The authors tried to evaluate multihance dynamic magnetic resonance imaging (MRI) as a new modality in early detection of hepatocellular carcinoma (HCC). Methods: Thirty cirrhotic patients with small hepatic focal lesions (less than 3 cm in diameter), detected by imaging (ultrasound and triphasic computed tomography) were subjected to dynamic MRI with multihance contrast. All patients had a liver biopsy stained with heat shock protein 70, glypican 3, and glutamine synthetase to confirm the diagnosis of HCC. Results: Eight out of 30 patients (26.6%) with atypical focal lesions proved to have HCC by histology, whereas 7 out of 8 histologically proven HCC patients (87.5%) were shown to have typical criteria on Multihance imaging. Conclusion: Multihance dynamic MRI is a promising diagnostic modality for detection of early HCC, however, future studies on large numbers of patients are warranted to precisely detect the sensitivity and specificity of this new modality.