Jin-Young Choi, Presenter: Nothing to Disclose

Myeong-Jin Kim MD, PhD, Abstract Co-Author: Nothing to Disclose

Yong Eun Chung MD, Abstract Co-Author: Nothing to Disclose

Song-Ee Baek MD, Abstract Co-Author: Nothing to Disclose

To compare diffusion-weighted imaging (DWI), gadoxetic acid-enhanced MRI alone and in combination for detection of hepatocellular carcinoma (HCC)

Sixty-six patients (57 men, 9 women; mean age 69.2 years) with HCC were examined at 3T MRI for detection of HCC. DWI (b values 50 and 800 sec/mm2) and dynamic gadoxetic acid-enhanced (Gdx) MRI in the arterial, portal venous, and equilibrium phase as well as 20 min hepatobiliary phase image were performed. Images were retrospectively reviewed by two radiologists to compare the diagnostic performance of DWI, Gdx MRI alone and in combination for detecting HCC with 5-point confidence level. Image quality was compared between DWI and Gdx MRI. Reference of standard for diagnosis of HCC was by histopathology (n=31) and follow-up imaging results (n=35). Alternative free response ROC analysis was used for statistical analysis.

From a total of 84 HCC, 75 lesions could be detected on Gdx MR imaging (89%) and 64 lesions were detected on DWI (76%). The Az values of DWI and Gdx MR imaging of both reviewers for detecting HCC were not statistically significant (Az for DWI= 0.818 and 0.864, Az for Gdx MR=0.902 and 0.842) (P=0.107 for reviewer 1 and P=0.738 for reviewer 2). Combined interpretation of both DWI and Gdx MRI did not increase the diagnostic performance of detecting HCC (Az for reviewer 1=0.862 and Az for reviewer 2=0.896). All lesions detected on DWI were also seen on Gdx MRI, and eight lesions (0.7-2.3 cm) which were not seen on DWI were visualized by Gdx MRI. Image quality of Gdx MRI was superior to DWI in both reviewers (P<0.05).

Gadoxetic acid-enhanced MR imaging is slightly better than DWI for detection of HCC at 3T MR. Addition of DWI to Gdx MRI may not be helpful for detecting HCC.

For detection of HCC at 3T MR, DWI may not be necessary considering image quality, artifact, and diagnostic performance.

Choi, J, Kim, M, Chung, Y, Baek, S, Detection of Hepatocellular Carcinoma: Comparison of Gadoxetic Acid-enhanced MR, Diffusion-weighted Imaging, and Combination of Both Techniques at 3 T MR.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9005209.html