Hepatocellular carcinoma detection in liver cirrhosis: diagnostic performance of contrast-enhanced CT vs. MRI with extracellular contrast vs. gadoxetic acid.

Details

Serval ID
serval:BIB_F1D4A1B73CB6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Hepatocellular carcinoma detection in liver cirrhosis: diagnostic performance of contrast-enhanced CT vs. MRI with extracellular contrast vs. gadoxetic acid.
Journal
European radiology
Author(s)
Semaan S., Vietti Violi N., Lewis S., Chatterji M., Song C., Besa C., Babb J.S., Fiel M.I., Schwartz M., Thung S., Sirlin C.B., Taouli B.
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Publication state
Published
Issued date
02/2020
Peer-reviewed
Oui
Volume
30
Number
2
Pages
1020-1030
Language
english
Notes
Publication types: Comparative Study ; Evaluation Study ; Journal Article
Publication Status: ppublish
Abstract
To evaluate the diagnostic performance of contrast-enhanced CT vs. MRI with extracellular contrast agents (EC-MRI) vs. MRI with gadoxetic acid (EOB-MRI) for HCC detection in patients with liver cirrhosis using liver explant as the reference. The additional value of hepatobiliary phase (HBP) post Gadoxetic acid was also assessed.
Two-hundred seventy-seven consecutive patients who underwent liver transplantation over a 9 year period and imaging within 90 days of were retrospectively included. Imaging consisted in CT (n = 100), EC-MRI (n = 77) and EOB-MRI (n = 100), the latter subdivided into dynamic EOB-MRI and full EOB-MRI (dynamic+HBP). Three radiologists retrospectively categorized lesions ≥ 1 cm using the LI-RADSv2017 algorithm. Dynamic EOB-MRI was re-evaluated with the addition of HBP. Results were correlated with explant pathology.
Pathology demonstrated 265 HCCs (mean size 2.1 ± 1.4 cm) in 177 patients. Per-patient sensitivities were 86.3% for CT, 89.5% for EC-MRI, 92.8% for dynamic EOB-MRI and 95.2% for full EOB-MRI (pooled reader data), with a significant difference between CT and dynamic/full EOB-MRI (p = 0.032/0.002), and between EC-MRI and full EOB-MRI (p = 0.047). Per-lesion sensitivities for CT, EC-MRI, dynamic EOB-MRI and full EOB-MRI were 59.5%,78.5%,69.7% and 76.8%, respectively, with a significant difference between MRI groups and CT (p-range:0.001-0.04), and no difference between EC-MRI and dynamic EOB-MRI (p = 0.949). For HCCs 1-1.9 cm, sensitivities were 34.4%, 64.6%, 57.3% and 67.3%, respectively, with all MRI groups significantly superior to CT (p ≤ 0.01) and full EOB-MRI superior to dynamic EOB-MRI (p = 0.002).
EOB-MRI outperforms CT and EC-MRI for per-patient HCC detection sensitivity, and is equivalent to EC-MRI for per-lesion sensitivity. MRI methods outperform CT for detection of HCCs 1-1.9 cm.
• MRI is superior to CT for HCC detection in patients with liver cirrhosis. • EOB-MRI outperforms CT and MRI using extracellular contrast agents (EC-MRI) for per-patient HCC detection sensitivity, and is equivalent to EC-MRI for per-lesion sensitivity. • The addition of hepatobiliary phase images improves HCC detection when using gadoxetic acid.
Keywords
Adult, Aged, Carcinoma, Hepatocellular/diagnostic imaging, Carcinoma, Hepatocellular/etiology, Carcinoma, Hepatocellular/pathology, Carcinoma, Hepatocellular/surgery, Contrast Media, False Positive Reactions, Female, Gadolinium DTPA, Humans, Liver Cirrhosis/complications, Liver Cirrhosis/diagnostic imaging, Liver Neoplasms/diagnostic imaging, Liver Neoplasms/pathology, Liver Neoplasms/surgery, Liver Transplantation, Magnetic Resonance Imaging/methods, Male, Middle Aged, Retrospective Studies, Sensitivity and Specificity, Tomography, X-Ray Computed/methods, Contrast media, Liver neoplasms, Magnetic resonance imaging, Tomography, spiral computed
Pubmed
Web of science
Create date
02/11/2019 23:40
Last modification date
19/06/2020 6:21
Usage data