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Comparison of the current guidelines for diagnosing hepatocellular carcinoma using gadoxetic acid-enhanced magnetic resonance imaging

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dc.contributor.author김승업-
dc.contributor.author박미숙-
dc.contributor.author박영년-
dc.contributor.author임준석-
dc.date.accessioned2021-09-29T02:00:26Z-
dc.date.available2021-09-29T02:00:26Z-
dc.date.issued2021-07-
dc.identifier.issn0938-7994-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/184662-
dc.description.abstractObjectives: To compare the performance of current guidelines applicable to the diagnosis of hepatocellular carcinomas (HCCs) using gadoxetic acid-enhanced magnetic resonance imaging (MRI). Methods: Two hundred and forty-one hepatic lesions (149 HCCs, six other malignancies, 86 benign lesions) in 177 patients at risk of HCC without a history of previous treatment for hepatic malignancy in a tertiary center were retrospectively reviewed. Either histopathology results or long-term (> 24 months) follow-up images were used as a standard of reference. All lesions were categorized according to the Liver Imaging Reporting and Data System (LI-RADS), European Association for the Study of the Liver (EASL), Asian Pacific Association for the Study of the Liver (APASL), and Korean Liver Cancer Study Group-National Cancer Center (KLCSG-NCC) guidelines. The sensitivity and specificity thereof were assessed using a generalized estimation equation. Results: For gadoxetic acid-enhanced MRI, LI-RADS (95%, 95% confidence interval [CI] 88-98) and EASL (94%, 95% CI 86-97) yielded the highest specificity, while EASL yielded the lowest sensitivity (54% [95% CI 46-62]). APASL yielded the highest sensitivity (91% [95% CI 86-95]) with the lowest specificity (78% [95% CI 69-86]). KLCSG-NCC showed balanced sensitivity (85% [79-90]) and specificity (88% [95% CI 80-93]). Differences were more prominent in small nodules between 1 and 2 cm. Conclusion: The diagnostic performance of current guidelines for HCC on gadoxetic acid-enhanced MRI was significantly different, and a potential inverse association between sensitivity and specificity was observed. Key points: • EASL and LI-RADS yielded the highest specificity with the lowest sensitivity, whereas APASL yielded the highest sensitivity with the lowest specificity. • Differences in the diagnostic performances of guidelines were prominent in small nodules between 1 and 2 cm. • Additional evaluation of CT findings improved the diagnostic sensitivity and accuracy of EASL and LI-RADS. Although doing so decreased specificity, it remained above 89-90%.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherSpringer International-
dc.relation.isPartOfEUROPEAN RADIOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHCarcinoma, Hepatocellular* / diagnostic imaging-
dc.subject.MESHContrast Media-
dc.subject.MESHGadolinium DTPA-
dc.subject.MESHHumans-
dc.subject.MESHLiver Neoplasms* / diagnostic imaging-
dc.subject.MESHMagnetic Resonance Imaging-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHSensitivity and Specificity-
dc.titleComparison of the current guidelines for diagnosing hepatocellular carcinoma using gadoxetic acid-enhanced magnetic resonance imaging-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorShin Hye Hwang-
dc.contributor.googleauthorMi-Suk Park-
dc.contributor.googleauthorSumi Park-
dc.contributor.googleauthorJoon Seok Lim-
dc.contributor.googleauthorSeung Up Kim-
dc.contributor.googleauthorYoung Nyun Park-
dc.identifier.doi10.1007/s00330-020-07468-3-
dc.contributor.localIdA00654-
dc.contributor.localIdA01463-
dc.contributor.localIdA01563-
dc.contributor.localIdA03408-
dc.relation.journalcodeJ00851-
dc.identifier.eissn1432-1084-
dc.identifier.pmid33409787-
dc.identifier.urlhttps://link.springer.com/article/10.1007%2Fs00330-020-07468-3-
dc.subject.keywordCarcinoma, hepatocellular-
dc.subject.keywordDiagnosis-
dc.subject.keywordGadolinium DTPA-
dc.subject.keywordGuideline-
dc.subject.keywordMagnetic resonance imaging-
dc.contributor.alternativeNameKim, Seung Up-
dc.contributor.affiliatedAuthor김승업-
dc.contributor.affiliatedAuthor박미숙-
dc.contributor.affiliatedAuthor박영년-
dc.contributor.affiliatedAuthor임준석-
dc.citation.volume31-
dc.citation.number7-
dc.citation.startPage4492-
dc.citation.endPage4503-
dc.identifier.bibliographicCitationEUROPEAN RADIOLOGY, Vol.31(7) : 4492-4503, 2021-07-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers

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