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Interobserver Variability and Diagnostic Performance of Gadoxetic Acid-enhanced MRI for Predicting Microvascular Invasion in Hepatocellular Carcinoma

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dc.date.accessioned2022-09-01T01:18:13Z-
dc.date.available2022-09-01T01:18:13Z-
dc.date.issued2020-12-
dc.identifier.issn0033-8419-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/189896-
dc.description.abstractBackground: Accurate identification of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) before treatment is critical for selecting a proper treatment strategy. Purpose: To evaluate the interobserver agreement and the diagnostic performance of the MRI assessment of MVI in HCC according to the level of radiologist experience. Materials and Methods: This retrospective study included 100 patients with surgically confirmed HCCs smaller than 5 cm who underwent gadoxetic acid-enhanced MRI between 2013 and 2016. Eight postfellowship radiologists (four with 7-13 years of experience [more experienced] and four with 3-6 years of experience [less experienced]) evaluated four imaging features (nonsmooth tumor margin, irregular rim-like enhancement in the arterial phase, peritumoral arterial phase hyperenhancement, peritumoral hepatobiliary phase hypointensity) and assigned the possibility of MVI. Interobserver agreement was determined by using Fleiss k statistics according to reviewer experience and tumor size (<= 3 cm vs >3 cm). With reference standards of histopathologic specimens, the diagnostic performance in the identification of MVI was assessed by using receiver operating characteristic curve analysis. Results: In 100 patients (mean age, 58 years +/- 10 [standard deviation]; 70 men) with 100 HCCs (mean size, 2.8 cm +/- 0.9), 39 (39%) HCCs had MVI. The overall interobserver agreement was fair to moderate for the imaging features and their combinations (k = 0.38-0.47) and MVI probability (k = 0.41; 95% confidence interval: 0.33, 0.45). More experienced reviewers demonstrated higher agreement in MVI probability than less experienced reviewers (k = 0.55 vs 0.36, respectively; P = .002). Diagnostic performance of each reviewer was modest for MVI prediction (area under the receiver operating characteristic curve [AUC] range, 0.60-0.74). The AUCs for the diagnosis of MVI were lower for HCCs larger than 3 cm (range, 0.55-0.69) than for those less than or equal to 3 cm (range, 0.59-0.75). Conclusion: Considerable interobserver variability exists in the assessment of microvascular invasion in hepatocellular carcinoma using MRI, even for more experienced radiologists.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherRadiological Society of North America-
dc.relation.isPartOfRADIOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHCarcinoma, Hepatocellular / pathology*-
dc.subject.MESHClinical Competence*-
dc.subject.MESHContrast Media-
dc.subject.MESHFemale-
dc.subject.MESHGadolinium DTPA-
dc.subject.MESHHumans-
dc.subject.MESHLiver Neoplasms / pathology*-
dc.subject.MESHMagnetic Resonance Imaging / methods*-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHNeoplasm Invasiveness / pathology*-
dc.subject.MESHObserver Variation-
dc.subject.MESHPredictive Value of Tests-
dc.subject.MESHRetrospective Studies-
dc.titleInterobserver Variability and Diagnostic Performance of Gadoxetic Acid-enhanced MRI for Predicting Microvascular Invasion in Hepatocellular Carcinoma-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Radiology (영상의학교실)-
dc.contributor.googleauthorJi Hye Min-
dc.contributor.googleauthorMin Woo Lee-
dc.contributor.googleauthorHee Sun Park-
dc.contributor.googleauthorDong Ho Lee-
dc.contributor.googleauthorHyun Jeong Park-
dc.contributor.googleauthorSanghyeok Lim-
dc.contributor.googleauthorSeo-Youn Choi-
dc.contributor.googleauthorJisun Lee-
dc.contributor.googleauthorJi Eun Lee-
dc.contributor.googleauthorSang Yun Ha-
dc.contributor.googleauthorDong Ik Cha-
dc.contributor.googleauthorKeumhee Chough Carriere-
dc.contributor.googleauthorJoong Hyun Ahn-
dc.identifier.doi10.1148/radiol.2020201940-
dc.relation.journalcodeJ02596-
dc.identifier.eissn1527-1315-
dc.identifier.pmid32990512-
dc.identifier.urlhttps://pubs.rsna.org/doi/10.1148/radiol.2020201940-
dc.citation.volume297-
dc.citation.number3-
dc.citation.startPage573-
dc.citation.endPage581-
dc.identifier.bibliographicCitationRADIOLOGY, Vol.297(3) : 573-581, 2020-12-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers

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