Contribution of the hepatobiliary phase of Gd-EOB-DTPAenhanced MRI to Dynamic MRI in the detection of hypovascular small (.2 cm) HCC in cirrhosis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Rita Golfieri & Matteo Renzulli & Vincenzo Lucidi & Beniamino Corcioni & Franco Trevisani & Luigi Bolondi
- چاپ و سال / کشور: 2011
Description
Objective To prospectively assess the additional value of the hepatobiliary (HB) phase of Gd-EOB-DTPA-MRI in identifying and characterising small (.2 cm) hepatocellular carcinomas (HCCs) undetermined in dynamic phases alone because of their atypical features, according to the AASLD criteria. Methods 127 cirrhotic patients were evaluated with Gd- EOB-DTPA-MRI in two sets: unenhanced and dynamic phases; unenhanced, dynamic and HB phases. Sixty-two out of 215 nodules (29%) were atypical in 42 patients (33%). Results 62 atypical nodules were reported at histology: high-grade dysplastic nodules (HGDN)/early HCC (n=20), low-grade DN (LGDN) (n=21), regenerative nodules (n= 17) and nodular regenerative hyperplasia (n=4). The sensitivity, specificity, accuracy, positive and negative predictive value (PPV, NPV) were increased by the addition of the HB phase: 88.4.99.4%, 88.95%, 88.98.5%, 97. 99%, and 65.97.5%, respectively. Twenty atypical nodules were malignant (32%), 19 of which were characterised only during the HB phase. Conclusions The HB phase is 11% more sensitive in the classification of HGDN/early HCC than dynamic MRI, with an added value of 32.5% in the NPV. The high incidence (33%) of atypical nodules and their frequent malignancy (32%) suggest the widespread employment of Gd-EOB-DTPA-MRI in the follow-up of small nodules (.2 cm) in cirrhosis.
Eur Radiol (2011) 21:1233–1242 DOI 10.1007/s00330-010-2030-1 Received: 23 June 2010 / Revised: 15 September 2010 / Accepted: 20 October 2010 / Published online: 5 February 2011
