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

 Sung Soo Ahn  ;  Myeong-Jin Kim  ;  Joon Seok Lim  ;  Hye-Suk Hong  ;  Yong Eun Chung  ;  Jin-Young Choi 
 RADIOLOGY, Vol.255(2) : 459-466, 2010 
Journal Title
Issue Date
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 ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity
PURPOSE: To determine the added value of hepatobiliary phase images in gadoxetic acid-enhanced magnetic resonance (MR) imaging in the evaluation of hepatocellular carcinoma (HCC).

MATERIALS AND METHODS: 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.

RESULTS: 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.

CONCLUSION: Hepatobiliary phase images obtained after gadoxetic acid-enhanced dynamic MR imaging may improve diagnosis of HCC and assist in surgical planning.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-0503-5558
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
Hong, Hye Suk(홍혜숙) ORCID logo https://orcid.org/0000-0001-7398-2517
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