Gadoxetic acid‐enhanced MRI versus multiphase multidetector row computed tomography for evaluating the viable tumor of hepatocellular carcinomas treated with image‐guided tumor therapy

Abstract

Purpose: To compare the diagnostic performance of gadoxetic acid-enhanced MRI with that of multi-phase 40-or 64-multidetector row computed tomography (MDCT) to evaluate viable tumors of hepatocellular carcinomas (HCCs) treated with image-guided tumor therapy. Materials and Methods:A total of 108 patients with 162 HCCs (56 lesions with viable tumor and 106 without viable tumor) treated by means of transcatheter arterial chemoembolization or radiofrequency ablation were retrospectively included in this study. All patients underwent multi-phase CT at 40-or 64-MDCT and gadoxetic acidenhanced MRI using 3.0 Tesla (T). Two observers independently and randomly reviewed the CT and MR images of the treated lesions. The diagnostic performance of two techniques for the evaluation of the viable tumors in the treated lesions was assessed with a receiver operating characteristic (ROC) analysis.Results: For each observer, the areas under the ROC curve were 0.953 and 0.969 for MRI, and 0.870 and 0.888 for MDCT (P < 0.05). The diagnostic accuracies (96.3% for each observer) and sensitivities (92.9% and 96.4%) of MRI in two observers were significantly higher than those (82.7% and 80.9%, 53.6% for each observer, respectively) of MDCT (P < 0.001). The negative predictive values (96.3% and 98.1%) of MRI in two observers were significantly higher than those (80.0% and 79.5%) of MDCT (P < 0.001). For each observer, specificities and positive predictive values did not differ significantly between the two techniques (P > 0.05). Conclusion:Gadoxetic acid-enhanced MRI shows better diagnostic performance than that of MDCT for evaluating the viable tumors of HCCs treated with image-guided tumor therapy.

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

“…Kim et al [24] reported that Gd-EOB-DTPA-enhanced MRI had diagnostic performance similar to dynamic MDCT in patients with relatively large tumor sizes with a median size of 2.9 cm (range, 0.5-10.5 cm), while MRI might be better than dynamic MDCT in the detection of HCC ≤1 cm in diameter. Hwang et al [14] retrospectively compared the diagnostic performance of Gd-EOB-DTPA-enhanced MRI with that of dynamic MDCT to evaluate recurrence after transcatheter arterial chemoembolization or RFA. They found that Gd-EOB-DTPA-enhanced MRI had better diagnostic performance than dynamic MDCT for evaluating the recurrence following either treatment.…”

“…Focally decreased enhancement in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI in the early stage of multistep hepatocarcinogenesis can signal early HCC [9,10,11,12]. 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].…”

The effects of hypotonic and isotonic negative contrast agent on gastrointestinal distention and physiological intake of 18F-FDG

“…However, PET/CT can have poor specificity because of physiological 18 F-FDG intake, which can be confused with pathological intake under certain circumstances [4][5][6]. Meanwhile, unclear display of bowel structure has been confused with pathological changes when the gastrointestinal tract was poorly distended [5,7,8].…”

“…However, PET/CT imaging has some disadvantages, such as poor imaging of the gastrointestinal tract and its physiological intake of fluorine-18 fluorodeoxyglucose ( 18 F-FDG), which could seriously affect the diagnosis and assessment of gastrointestinal diseases and thus cause misdiagnosis [2,3]. Because of the iterative algorithm of PET/CT, positive oral contrast agents can cause image artifacts, which should be limited clinically [4]. Accordingly, some researchers have attempted to use negative oral contrast agents for better display of bowel morphology and a reduction in the physiological intake of 18 F-FDG [5].…”

MRI Findings of Lipiodol Uptake in Hepatocellular Carcinomas: A Focus on Signal Intensity

“…TACE using ethiodized oil (Lipiodol, Laboratoire Guerbet, Villepinte, France) mixed with anticancerous agents, has been widely performed. Lipiodol transports the anticancerous drug, and the arterial embolic material helps increase the effect of the anticancerous drug [7].…”