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Vanishing washout of hepatocellular carcinoma according to the presence of hepatic steatosis: diagnostic performance of CT and MRI

Authors
 Ji Hye Min  ;  Tae Wook Kang  ;  Yeon-Yoon Kim  ;  Dong Ik Cha  ;  Young Kon Kim  ;  Seong Hyun Kim  ;  Dong Hyun Sinn  ;  Sang Yun Ha  ;  Kyunga Kim 
Citation
 EUROPEAN RADIOLOGY, Vol.31(5) : 3315-3325, 2021-05 
Journal Title
EUROPEAN RADIOLOGY
ISSN
 0938-7994 
Issue Date
2021-05
MeSH
Carcinoma, Hepatocellular* / complications ; Carcinoma, Hepatocellular* / diagnostic imaging ; Contrast Media ; Fatty Liver* / complications ; Fatty Liver* / diagnostic imaging ; Gadolinium DTPA ; Humans ; Liver Neoplasms* / diagnostic imaging ; Magnetic Resonance Imaging ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed
Keywords
Diagnosis ; Fatty liver ; Hepatocellular carcinoma ; Magnetic resonance imaging ; Multidetector computed tomography
Abstract
Objectives: To compare the presence of washout and the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI) for hepatocellular carcinoma (HCC) according to the presence of hepatic steatosis.

Methods: This retrospective study included 566 patients with chronic liver disease who had undergone hepatic resection for hepatic tumors (482 HCCs and 84 non-HCCs) between January 2016 and June 2018 and had available multiphasic CT and MR images. Patients were allocated in the fatty liver (n = 141) or non-fatty liver (n = 425) group according to the presence of hepatic steatosis, defined as lipid droplets in at least 5% of hepatocytes on pathological examination. The presence of HCC washout and the diagnostic performance of CT and MRI for HCC were compared between the groups.

Results: HCC washout was less frequently seen in the fatty liver group than in the non-fatty liver group on CT (61.5% vs. 88.9%, p < 0.001), whereas it was similarly present on MRI in both groups (77.0% vs. 74.4%, p = 0.565). For diagnosis of HCC, the sensitivity (53.3% vs. 80.0%, p < 0.001) and accuracy (53.9% vs. 80.9%, p < 0.001) of CT were lower in the fatty liver group than in the non-fatty liver group. However, for MRI, these values were not significantly different between the groups (p > 0.05).

Conclusions: Hepatic steatosis significantly decreased the performance of CT for the diagnosis of HCC, whereas it did not significantly alter the performance of MRI.

Key points: • Unlike MRI, there is vanishing HCC washout on CT caused by the background hepatic steatosis. • The diagnostic performance of CT for the diagnosis of HCC was significantly altered by hepatic steatosis. • The optimal cutoff HU value of the liver parenchyma for the vanishing washout of HCC was < 50 HU on unenhanced CT images.
Full Text
https://link.springer.com/article/10.1007/s00330-020-07438-9
DOI
10.1007/s00330-020-07438-9
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yeun-Yoon(김연윤) ORCID logo https://orcid.org/0000-0003-2018-5332
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190922
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