Abstract:
OBJECTIVES:To validate new diagnostic criteria for hepatocellular carcinoma (HCC) on gadoxetic acid-enhanced MR imaging (Gd-EOB-MRI) using hypointensity on the hepatobiliary phase (HBP) as an alternative to washout in combination with ancillary features. METHODS:This retrospective study included 288 patients at high risk for HCC with 387 nodules (HCCs, n=292; non-HCCs, n=95) showing arterial phase hyper-enhancement (APHE) ≥1 cm on Gd-EOB-MRI. Imaging diagnoses of HCCs were made using different criteria: APHE plus hypointensity on the portal venous phase (PVP) (criterion 1), APHE plus hypointensity on the PVP and/or transitional phase (TP) (criterion 2), APHE plus hypointensity on the PVP and/or TP and/or HBP (criterion 3), and criterion 3 plus non-LR-1/2/M according to the Liver Imaging Reporting and Data System (LI-RADS) v2017 considering ancillary features (criterion 4). Sensitivities and specificities of those criteria were compared using McNemar's test. RESULTS:Among diagnostic criteria for HCCs, criteria 3 and 4 showed significantly higher sensitivities (93.8% and 92.5%, respectively) than criteria 1 and 2 (70.9% and 86.6%, respectively) (p values <0.001). The specificity of criterion 4 (87.4%) was shown to be significantly higher than that of criterion 3 (48.4%, p<0.001), albeit comparable to criterion 2 (86.3%, p>0.999) and significantly lower than criterion 1 (97.9%, p=0.002). CONCLUSIONS:In the non-invasive diagnosis of HCCs on Gd-EOB-MRI, HBP hypointensity may be used as an alternative to washout enabling a highly sensitive diagnosis with little loss in specificity if it is used after excluding nodules considered to be benignities or non-HCC malignancies based on characteristic imaging features. KEY POINTS:• Gd-EOB-MRI enhancement and ancillary features can be used to diagnose HCC. • Exclusion of LR-1/2/M improves specificity when HBP hypointensity is used.
journal_name
Eur Radioljournal_title
European radiologyauthors
Joo I,Lee JM,Lee DH,Jeon JH,Han JKdoi
10.1007/s00330-018-5727-1subject
Has Abstractpub_date
2019-04-01 00:00:00pages
1724-1732issue
4eissn
0938-7994issn
1432-1084pii
10.1007/s00330-018-5727-1journal_volume
29pub_type
杂志文章abstract:OBJECTIVE:To investigate the detection rate of pulmonary nodules in ultralow-dose CT acquisitions. MATERIALS AND METHODS:In this lung phantom study, 232 nodules (115 solid, 117 ground-glass) of different sizes were randomly distributed in a lung phantom in 60 different arrangements. Every arrangement was acquired once...
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更新日期:1996-01-01 00:00:00
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