Intraindividual Comparison of Gadoxetate Disodium–enhanced MR Imaging and 64-Section Multidetector CT in the Detection of Hepatocellular Carcinoma in Patients with Cirrhosis

Martino, Michele Di; Marin, Daniele; Guerrisi, Antonino; Baski, Mahbubeh; Galati, Francesca; Rossi, Massimo; Brozzetti, Stefania; Masciangelo, Raffaele; Passariello, Roberto; Catalano, Carlo

doi:10.1148/radiol.10091334

Cited by 240 publications

(178 citation statements)

References 40 publications

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“…64,65 Several studies have shown that gadoxetic acid-enhanced MR imaging is useful in diagnosing conventional HCCs and, in fact, may sometimes be more reliable than dynamic contrast-enhanced 16-to 64-slice multidetector-row CT for this purpose. 9,36,66,67 When using an extracellular GBCA, sensitivity and specicity of MR imaging are excellent even for small HCCs. 68 However, some researchers suggest that the hepatocyte phase of gadoxetic acid might have added value to detect more HCCs than dynamic phases especially for less-experienced observers.…”

Section: Added Value For Hepatocellular Carcinoma (Hcc) Improving Diamentioning

confidence: 99%

Rules, Roles, and Room for Discussion in Gadoxetic Acid-enhanced Magnetic Resonance Liver Imaging: Current Knowledge and Future Challenges

Ichikawa

Araki

2013

magn reson med sci

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Since its launch onto the world medical market, gadoxetic acid has received a great deal of attention from a diverse group of researchers, including gastroenterologists, hepatologists, and abdominal radiologists. Gadoxetic acid in liver magnetic resonance (MR) imaging might be considered to have excellent utility. However, several issues remain that radiologists should keep in mind when utilizing this product. We compiled this review to introduce gadoxetic acid, describe how it should be used, highlight the situations in which it is most and least reliable, and suggest potential avenues for future research.

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Section: Added Value For Hepatocellular Carcinoma (Hcc) Improving Diamentioning

confidence: 99%

Rules, Roles, and Room for Discussion in Gadoxetic Acid-enhanced Magnetic Resonance Liver Imaging: Current Knowledge and Future Challenges

Ichikawa

Araki

2013

magn reson med sci

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“…Gadoxetate disodium, a recently introduced hepatobiliary contrast agent, is widely used to improve detection and characterization of HCC (17)(18)(19)(20)(21). In clinical practice, we have observed areas of hypointensity around some HCCs on hepatobiliary phase images of gadoxetate disodium-enhanced MRI (EOB-MRI).…”

mentioning

confidence: 99%

Prediction of microvascular invasion of hepatocellular carcinoma: Usefulness of peritumoral hypointensity seen on gadoxetate disodium‐enhanced hepatobiliary phase images

Kim

Jeon

et al. 2011

Magnetic Resonance Imaging

164

150

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Purpose: To determine whether peritumoral hypointensity seen on hepatobiliary phase images of preoperative gadoxetate disodium-enhanced magnetic resonance imaging (EOB-MRI) is useful for predicting microvascular invasion of hepatocellular carcinoma (HCC). Materials and Methods:This study was approved by the Institutional Review Board. In all, 104 HCC masses in 104 patients who had undergone EOB-MRI and liver surgery within 1 month after EOB-MRI were evaluated. Two radiologists independently recorded the presence of a peritumoral hypointensity on hepatobiliary phase. Interobserver agreement was assessed and consensus records were used. Tumor size was measured. A chi-square test and independent t-test were used for univariate analysis. Multiple logistic regression was performed to determine factors for predicting microvascular invasion. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of peritumoral hypointensity were calculated.Results: Sixty HCCs had microvascular invasion and 44 did not. Interobserver agreement in determining peritumoral hypointensity was excellent (k ¼ 0.83). By univariate analysis, peritumoral hypointensity and tumor size were significant for predicting microvascular invasion of HCC. On multiple logistic regression analysis, only peritumoral hypointensity was significant in predicting microvascular invasion of HCC (P ¼ 0.013). The sensitivity, specificity, PPV, and NPV of peritumoral hypointensity were 38.3%, 93.2%, 88.5%, and 52.6%, respectively. Conclusion:Peritumoral hypointensity on the hepatobiliary phase of EOB-MRI is not sensitive but has high specificity for predicting microvascular invasion of HCC.

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“…[13][14][15] Therefore, this technique may more readily detect early-stage lesions than CT arterial portography, 16 which was believed to have the highest sensitivity for this purpose. 9 The increased use of gadoxetic acid for routine examination may lead to the more frequent detection of hypovascular nodules that are hypointense on hepatocyte-phase (15 to 20 min after administration of gadoxetic acid) images of gadoxetic acidenhanced MR imaging.…”

Section: Magnetic Resonance In Medical Sciencesmentioning

confidence: 99%

Natural Course of Hypovascular Nodules Detected on Gadoxetic Acid-enhanced MR Imaging: Presence of Fat is a Risk Factor for Hypervascularization

et al. 2013

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Purpose: Hypovascular nodules that exhibit hypointensity in hepatocyte-phase images of gadoxetic acid-enhanced magnetic resonance (MR) imaging are frequently encountered in clinical practice. We investigated risk factors for the development of these nodules into hypervascular hepatocellular carcinoma (HCC).Methods: We retrospectively reviewed our institutional database and identiˆed 302 patients who underwent gadoxetic acid-enhanced MR imaging for suspected or conˆrmed HCC from February 1, 2008 to January 30, 2011. We excluded patients who were examined for metastasis of other malignancies or for other hepatic tumors, such as focal nodular hyperplasia. We identiˆed hypovascular nodules that were hypointense in hepatocytephase images, recorded their characteristics, and calculated the cumulative hypervascularization rate for nodules that were followed up.Results: Of the 302 patients, 82 had hypovascular nodules (178 nodules; mean size, 9.3 mm). Sixty nodules were followed up for over 6 months, and eight progressed to hypervascular HCC. Hypervascularization occurred more frequently in nodules with fat than those without (Pº0.01). The cumulative hypervascularization rate was 5.1z over a year.Conclusion: The presence of intralesional fat was found to be a risk factor for hypervascularization of hypovascular nodules that exhibited hypointensity in the hepatocyte-phase images of gadoxetic acid-enhanced MR imaging.

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Intraindividual Comparison of Gadoxetate Disodium–enhanced MR Imaging and 64-Section Multidetector CT in the Detection of Hepatocellular Carcinoma in Patients with Cirrhosis

Abstract: Compared with multiphasic 64-section multidetector CT, gadoxetate disodium-enhanced MR imaging yields significantly higher diagnostic accuracy and sensitivity in the detection of HCC in patients with cirrhosis.

Cited by 240 publications

References 40 publications

Rules, Roles, and Room for Discussion in Gadoxetic Acid-enhanced Magnetic Resonance Liver Imaging: Current Knowledge and Future Challenges

Rules, Roles, and Room for Discussion in Gadoxetic Acid-enhanced Magnetic Resonance Liver Imaging: Current Knowledge and Future Challenges

Prediction of microvascular invasion of hepatocellular carcinoma: Usefulness of peritumoral hypointensity seen on gadoxetate disodium‐enhanced hepatobiliary phase images

Natural Course of Hypovascular Nodules Detected on Gadoxetic Acid-enhanced MR Imaging: Presence of Fat is a Risk Factor for Hypervascularization

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