MRI characterization of 124 CT-indeterminate focal hepatic lesions: evaluation of clinical utility

Elsayes, Khaled M.; Leyendecker, John R.; Menias, Christine O.; Oliveira, E. P.; Narra, Vamsidhar R.; Chapman, William C.; Hassanien, Moataz; El-Sharkawy, Mohamed S.; Brown, Jeffrey J.

doi:10.1080/13651820701216950

Cited by 30 publications

(17 citation statements)

References 40 publications

(80 reference statements)

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“…Conventional dynamic contrast-enhanced MRI (cDCE-MRI) suffers limitations in characterization of focal hepatic lesions secondary to overlapping enhancement characteristics or variable appearances of lesions [1], [2]. This shortcoming of cDCE-MRI has been improved through the utilization of additional hepatic MR imaging techniques such as diffusion-weighted imaging (DWI) [3] and hepatocyte-specific contrast agents [4].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Dynamic and Liver-Specific Gadoxetic Acid Contrast-Enhanced MRI versus Apparent Diffusion Coefficients

et al. 2013

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BackgroundHepatic lesions often present diagnostic connundrums with conventional MR techniques. Hepatobiliary phase contrast-enhanced imaging with gadoxetic acid can aid in the characterization of such lesions. However, quantitative measures describing late-phase enhancement must be assessed relative to their accuracy of hepatic lesion classification.Purpose: To compare quantitative parameters in gadoxetic acid contrast-enhanced dynamic and hepatobiliary phase imaging versus apparent diffusion coefficients in hepatic lesion characterization.Material and Methods57 patients with focal hepatic lesions on gadoxetic acid MR were included. Lesion enhancement at standard post-contrast time points and in the hepatobiliary phase (HB; 15 and 25 minutes post-contrast) was assessed via calculation of contrast (CR) and enhancement ratios (ER). Apparent diffusion coefficient (ADC) values were also obtained. Values for these parameters were compared among lesions and ROC analyses performed.Results: HB enhancement was greatest with FNH and adenomas. HB ER parameters but not HB CR could distinguish HCC from benign entities (0.9 ER ROC AUC versus 0.5 CR ROC AUC). There was no statistically significant difference found between the 15 and 25 minutes HB time points in detection of any lesion (p>0.4). ADC values were statistically significantly higher with hemangiomas (p<0.05) without greater accuracy in lesion detection relative to HB phase parameters.ConclusionHepatobiliary phase gadoxetic acid contrast-enhanced MR characterizes focal hepatic lesions more accurately than ADC and conventional dynamic post-contrast time point enhancement parameters. ER values are generally superior to CR. No discernible benefit of 25 minute versus 15 minute delayed imaging is demonstrated.

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Section: Introductionmentioning

confidence: 99%

Comparison of Dynamic and Liver-Specific Gadoxetic Acid Contrast-Enhanced MRI versus Apparent Diffusion Coefficients

et al. 2013

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“…Contrast-enhanced MR imaging is a highly accurate non-invasive imaging modality for the detection and characterization of solid hypervascular focal liver lesions and is the imaging method of choice for improved differential diagnosis in cases of equivocal or indeterminate lesions on ultrasonography or computed tomography [ 39 ] . However, it is not always possible to accurately diagnose a given lesion on conventional T1-weighted dynamic phase imaging because of overlapping enhancement patterns between different lesion types [ 7 ] .…”

Section: Clinical Applicationsmentioning

confidence: 99%

Use of contrast agents in oncological imaging: magnetic resonance imaging

Morana¹,

Cugini²,

Scatto³

et al. 2013

Cancer Imaging

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Magnetic resonance plays a leading role in the management of oncology patients, providing superior contrast resolution and greater sensitivity compared with other techniques, which enables more accurate tumor identification, characterization and staging. Contrast agents are widely used in clinical magnetic resonance imaging; approximately 40–50% of clinical scans are contrast enhanced. Most contrast agents are based on the paramagnetic gadolinium ion Gd3+, which is chelated to avoid the toxic effects of free gadolinium. Multiple factors such as molecule structure, molecule concentration, dose, field strength and temperature determine the longitudinal and transverse relaxation rates (R1 and R2, respectively) and thus the T1- and T2-relaxivities of these chelates. These T1- and T2-relaxivities, together with their pharmacokinetic properties (i.e. distribution and concentration in the area of interest), determine the radiologic efficacy of the gadolinium-based contrast agents.

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“…MR image quality can be affected by patient motion and most MR imaging protocols produce lower spatial resolution images than CT [3]. tomography/magnetic resonance imaging (PET/MRI) has been introduced [4].…”

Section: Introductionmentioning

confidence: 99%

The added value of PET/Ce-CT/DW-MRI fusion in assessment of hepatic focal lesions

Salem

Houseni

Zidan

et al. 2015

Nuclear Medicine and Biology

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MRI characterization of 124 CT-indeterminate focal hepatic lesions: evaluation of clinical utility

Abstract: MRI is valuable for the characterization of indeterminate focal hepatic lesions detected on CT.

Cited by 30 publications

References 40 publications

Comparison of Dynamic and Liver-Specific Gadoxetic Acid Contrast-Enhanced MRI versus Apparent Diffusion Coefficients

Comparison of Dynamic and Liver-Specific Gadoxetic Acid Contrast-Enhanced MRI versus Apparent Diffusion Coefficients

Use of contrast agents in oncological imaging: magnetic resonance imaging

The added value of PET/Ce-CT/DW-MRI fusion in assessment of hepatic focal lesions

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