Evaluation of Early-Stage Hepatocellular Carcinoma by Magnetic Resonance Imaging With Gadoxetic Acid Detects Additional Lesions and Increases Overall Survival

Kim, Hyung Don; Lim, Young Suk; Han, Seungbong; Kim, Gi Ae; Kim, So Yeon; Lee, So Jung; Byun, Jae Ho

doi:10.1053/j.gastro.2015.02.051

Cited by 115 publications

(113 citation statements)

References 48 publications

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“…Accordingly, Gd-EOB-DTPA-enhanced MRI was never used as the first imaging modality for detecting HCC. As a result, the median size of HCC in the report by Kim et al [21] (2.7 cm) was much larger than the size in our study (0.9 cm). To the best of our knowledge, our study is the first prospective study investigating the efficacy of Gd-EOB-DTPA-enhanced MRI for the evaluation of recurrence after RFA for HCC.…”

Section: Discussioncontrasting

confidence: 83%

“…Recent studies have reported that additional Gd-EOB-DTPA-enhanced MRI examinations found new intrahepatic HCC lesions in patients with BCLC stage 0 or A based on the diagnosis by conventional dynamic CT [20,21]. Moreover, additional evaluation by Gd-EOB-DTPA-enhanced MRI in the patients with a single HCC initially diagnosed by dynamic CT resulted in improved recurrence-free and overall survival [21].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, additional evaluation by Gd-EOB-DTPA-enhanced MRI in the patients with a single HCC initially diagnosed by dynamic CT resulted in improved recurrence-free and overall survival [21]. However, these studies were retrospectively conducted, and dynamic CT examination was performed as a first survey for HCC, followed by Gd-EOB-DTPA-enhanced MRI.…”

Section: Discussionmentioning

confidence: 99%

“…Gd-EOB-DTPA-enhanced MRI has been reported to have higher diagnostic accuracy and sensitivity compared with dynamic computed tomography (CT) and now plays an important role in the detection of HCCs [13,14,15,16,17,18,19]. Recent studies have reported that Gd-EOB-DTPA-enhanced MRI as an additional imaging modality to dynamic multidetector CT (MDCT) led to the detection of additional intrahepatic HCC lesions in patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 or A HCC and subsequent modification of treatment plans, which brought about improved recurrence-free and overall survival [20,21]. …”

Section: Introductionmentioning

confidence: 99%

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Prospective Comparison of Gd-EOB-DTPA-Enhanced MRI with Dynamic CT for Detecting Recurrence of HCC after Radiofrequency Ablation

Imai

Katayama

Hori³

et al. 2017

Liver Cancer

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Background: We prospectively compared the efficacy of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) with that of dynamic multidetector computed tomography (MDCT) for detection of recurrent hypervascular hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA). Methods: Institutional review board approval and written informed consent were obtained for this multicenter study. Ninety-seven HCC patients treated with curative RFA underwent both Gd-EOB-DTPA-enhanced MRI and dynamic MDCT every 3-4 months. HCC diagnosis was made based on the typical enhancement pattern of HCC on MRI and/or CT by on-site consensus reading. Two blinded observers independently assessed image datasets to compare diagnostic accuracy, sensitivity, specificity, and the areas under the receiver operating characteristic curve (AUROC). Results: Recurrence was observed in 48 of 97 patients. Among these, 22 were diagnosed by both Gd-EOB-DTPA-enhanced MRI and MDCT; the remainder were diagnosed by only one of these 2 modalities. Recurrence was diagnosed in more patients by Gd-EOB-DTPA-enhanced MRI than by MDCT (44 vs. 26 patients, p < 0.001). Patient-based analysis revealed that the accuracy, sensitivity, and AUROC of Gd-EOB-DTPA-enhanced MRI were significantly higher than those of MDCT for both observers (p < 0.005). The AUROC of Gd-EOB-DTPA- enhanced MRI and MDCT was 0.95 and 0.76 for observer 1 and 0.90 and 0.74 for observer 2, respectively. The κ values for MRI and MDCT were 0.83 and 0.70, respectively. Conclusions: Compared with dynamic MDCT, Gd-EOB-DTPA-enhanced MRI had higher diagnostic accuracy and sensitivity for detection of recurrent hypervascular HCC and may be a better tool for following patients after RFA.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prospective Comparison of Gd-EOB-DTPA-Enhanced MRI with Dynamic CT for Detecting Recurrence of HCC after Radiofrequency Ablation

Imai

Katayama

Hori³

et al. 2017

Liver Cancer

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“…Accordingly, Gd-EOB-MRI leads to the additional detection of HCCs in patients who were initially diagnosed as having single-nodular HCC on dynamic CT. This may therefore reduce the risk of disease recurrence and improve overall survival after curative treatment [40]. Gd-EOB-MRI has shown superior performance compared with those of CT or ECCM-enhanced MRI in detecting small HCCs [41][42][43][44].…”

Section: Small Hccmentioning

confidence: 99%

Recent Advances in the Imaging Diagnosis of Hepatocellular Carcinoma: Value of Gadoxetic Acid-Enhanced MRI

Joo

Lee

2015

Liver Cancer

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Magnetic resonance imaging (MRI) using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DPTA), or gadoxetic acid for short, is a hepatocyte-specific contrast agent which is now increasingly used for the detection and characterization of focal hepatic lesions, particularly in patients at high-risk of developing hepatocellular carcinomas (HCC). In fact, several recent guidelines now recognize gadoxetic acid-enhanced MRI (Gd-EOB-MRI) as the primary diagnostic imaging modality for the noninvasive diagnosis of HCC, although it must be noted that several major guidelines still include only extracellular contrast media-enhanced computed tomography and MRI. The primary merits of Gd-EOB-MRI lie in the fact that it can provide not only dynamic imaging, but also hepatobiliary phase (HBP) imaging which can lead to high lesion-to-liver contrast and give additional information regarding hepatocyte uptake via organic anion transporting polypeptides. This, in turn, allows higher sensitivity in detecting small HCCs and helps provide additional information regarding the multistep process of hepatocarcinogenesis. Indeed, many recent studies have investigated the diagnostic value of Gd-EOB-MRI for early HCCs as well as its role as a potential imaging biomarker in predicting outcome. We herein review the recent advances in the imaging diagnosis of HCCs focusing on the applications of Gd-EOB-MRI and the challenging issues that remain.

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MRI With Liver-Specific Contrast for Surveillance of Patients With Cirrhosis at High Risk of Hepatocellular Carcinoma

et al. 2017

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Evaluation of Early-Stage Hepatocellular Carcinoma by Magnetic Resonance Imaging With Gadoxetic Acid Detects Additional Lesions and Increases Overall Survival

Cited by 115 publications

References 48 publications

Prospective Comparison of Gd-EOB-DTPA-Enhanced MRI with Dynamic CT for Detecting Recurrence of HCC after Radiofrequency Ablation

Prospective Comparison of Gd-EOB-DTPA-Enhanced MRI with Dynamic CT for Detecting Recurrence of HCC after Radiofrequency Ablation

Recent Advances in the Imaging Diagnosis of Hepatocellular Carcinoma: Value of Gadoxetic Acid-Enhanced MRI

MRI With Liver-Specific Contrast for Surveillance of Patients With Cirrhosis at High Risk of Hepatocellular Carcinoma

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