Ontology type: schema:ScholarlyArticle
2015-10
AUTHORSIjin Joo, Jeong Min Lee, Dong Ho Lee, Ju Hyeon Jeon, Joon Koo Han, Byung Ihn Choi
ABSTRACTOBJECTIVES: To determine which dynamic phase(s) of gadoxetic acid-enhanced MRI is most appropriate to assess "washout" in the noninvasive diagnosis of hepatocellular carcinoma (HCC) based on hemodynamic pattern. METHODS: In this retrospective cohort study, 288 consecutive patients with chronic liver disease presented with 387 arterially enhancing nodules (292 HCCs, 95 non-HCCs) (≥1 cm) on gadoxetic acid-enhanced MRI. All HCCs were confirmed by histopathology or by their typical enhancement pattern on dynamic liver CT. MR imaging diagnosis of HCC was made using criteria of arterial enhancement and hypointensity relative to the surrounding parenchyma (1) on the portal-venous phase (PVP), (2) on the PVP and/or transitional phase (TP), or (3) on the PVP and/or TP, and/or hepatobiliary phase (HBP). RESULTS: For the noninvasive diagnosis of HCC, criterion 1 provided significantly higher specificity (97.9%; 95% confidence interval, 92.6 - 99.7%) than criteria 2 (86.3%; 77.7 - 92.5%), or 3 (48.4%; 38.0 - 58.9%). Conversely, higher sensitivity was obtained with criterion 3 (93.8%; 90.4 - 96.3%) than with criterion 2 (86.6%; 82.2 - 90.3%) or 1 (70.9%; 65.3 - 76.0%). CONCLUSIONS: To make a sufficiently specific diagnosis of HCC using gadoxetic acid-enhanced MRI based on typical enhancement features, washout should be determined on the PVP alone rather than combined with hypointensity on the TP or HBP. KEY POINTS: • Gadoxetic acid-enhanced MRI enhancement features can be used to diagnose HCC. • Washout should be determined on the PVP alone for high specificity. • Hypointensity on the TP or HBP increases sensitivity but lowers specificity. More... »
PAGES2859-2868
http://scigraph.springernature.com/pub.10.1007/s00330-015-3686-3
DOIhttp://dx.doi.org/10.1007/s00330-015-3686-3
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PUBMEDhttps://www.ncbi.nlm.nih.gov/pubmed/25773941
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"description": "OBJECTIVES: To determine which dynamic phase(s) of gadoxetic acid-enhanced MRI is most appropriate to assess \"washout\" in the noninvasive diagnosis of hepatocellular carcinoma (HCC) based on hemodynamic pattern.\nMETHODS: In this retrospective cohort study, 288 consecutive patients with chronic liver disease presented with 387 arterially enhancing nodules (292 HCCs, 95 non-HCCs) (\u22651 cm) on gadoxetic acid-enhanced MRI. All HCCs were confirmed by histopathology or by their typical enhancement pattern on dynamic liver CT. MR imaging diagnosis of HCC was made using criteria of arterial enhancement and hypointensity relative to the surrounding parenchyma (1) on the portal-venous phase (PVP), (2) on the PVP and/or transitional phase (TP), or (3) on the PVP and/or TP, and/or hepatobiliary phase (HBP).\nRESULTS: For the noninvasive diagnosis of HCC, criterion 1 provided significantly higher specificity (97.9%; 95% confidence interval, 92.6 - 99.7%) than criteria 2 (86.3%; 77.7 - 92.5%), or 3 (48.4%; 38.0 - 58.9%). Conversely, higher sensitivity was obtained with criterion 3 (93.8%; 90.4 - 96.3%) than with criterion 2 (86.6%; 82.2 - 90.3%) or 1 (70.9%; 65.3 - 76.0%).\nCONCLUSIONS: To make a sufficiently specific diagnosis of HCC using gadoxetic acid-enhanced MRI based on typical enhancement features, washout should be determined on the PVP alone rather than combined with hypointensity on the TP or HBP.\nKEY POINTS: \u2022 Gadoxetic acid-enhanced MRI enhancement features can be used to diagnose HCC. \u2022 Washout should be determined on the PVP alone for high specificity. \u2022 Hypointensity on the TP or HBP increases sensitivity but lowers specificity.",
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"name": "Noninvasive diagnosis of hepatocellular carcinoma on gadoxetic acid-enhanced MRI: can hypointensity on the hepatobiliary phase be used as an alternative to washout?",
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