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Added value of smooth hypointense rim in the hepatobiliary phase of gadoxetic acid-enhanced MRI in identifying tumour capsule and diagnosing hepatocellular carcinoma

 Chansik An  ;  Hyungjin Rhee  ;  Kyunghwa Han  ;  Jin-Young Choi  ;  Young-Nyun Park  ;  Mi-Suk Park  ;  Myeong-Jin Kim  ;  Sumi Park 
 EUROPEAN RADIOLOGY, Vol.27(6) : 2610-2618, 2017 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/diagnosis* ; Contrast Media ; Female ; Gadolinium DTPA ; Humans ; Liver Neoplasms/diagnosis* ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Sensitivity and Specificity
Diagnosis ; Gadoxetic acid ; Hepatocellular carcinoma ; Magnetic resonance imaging ; Sensitivity and specificity
OBJECTIVES: To examine the added value of considering smooth hypointense rim in the hepatobiliary phase (HBP) of gadoxetic acid-enhanced MRI as capsule appearance for diagnosing tumour capsules and hepatocellular carcinoma (HCC).

METHODS: A total of 377 hepatic lesions (330 HCCs, 35 non-HCC malignancies and 12 benign) were included from 345 patients who underwent resection after MRI between January 2008 and December 2011. Two radiologists assessed the presence or absence of conventional capsule appearance and smooth hypointense rim in the HBP, and categorized each hepatic lesion according to the Liver Imaging Reporting and Data System. Difference in diagnostic performance was evaluated using the generalized estimating equation method.

RESULTS: For identifying capsule, the sensitivity and accuracy of HBP hypointense rim were significantly higher than those of conventional capsule appearance (81.5 % vs. 57.8 % and 76.1 % vs. 59.4 %, respectively; P < 0.001). For diagnosing HCC, the sensitivity and accuracy of LR-5 or LR-5 V were significantly higher when the HBP hypointense rim was also considered capsule appearance (83 % vs. 72.7 % and 84.1 % vs. 75.1 %, respectively; P < 0.001), with the same specificity (91.5 %).

CONCLUSIONS: Regarding smooth hypointense rim in the HBP as capsule appearance could improve the detection of tumour capsule and the diagnosis of HCC.

KEY POINTS: • Identifying tumour capsule is important for diagnosis of hepatocellular carcinoma (HCC). • Gadoxetic acid-enhanced MRI provides hepatobiliary phase (HBP) images. • Smooth hypointense rim seen in HBP may represent tumour capsule. • Regarding smooth hypointense rim as capsule appearance may improve HCC diagnosis.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
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
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
An, Chansik(안찬식) ORCID logo https://orcid.org/0000-0002-0484-6658
Rhee, Hyungjin(이형진) ORCID logo https://orcid.org/0000-0001-7759-4458
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
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