Kumaresan Sandrasegaran MD, Abstract Co-Author: Research grant,Bayer AG

Raja Ramaswamy, Abstract Co-Author: Nothing to Disclose

Kyle Bertrand MD, Abstract Co-Author: Nothing to Disclose

Bilal Tahir MD, Presenter: Nothing to Disclose

Fatih Mustafa Akisik MD, Abstract Co-Author: Nothing to Disclose

Romil Saxena MD, Abstract Co-Author: Nothing to Disclose

To assess the role of hepatocellular phase following gadobenate in characterizing the grade of hepatocellular cancer (HCC) in cirrhotic patients.

A retrospective review of the MRI database from October 2004 to February 2009, performed for this IRB-approved and HIPAA-complaint study, revealed 237 cirrhotic patients with focal liver lesions. Patients who had a hepatocellular phase after gadobenate and pathological confirmation of HCC were included. 46 patients with 73 lesions were analyzed independently by two reviewers both qualitatively and quantitatively for signal characteristics. Absolute contrast-to-noise (CNR) and enhancement ratios (ER) were calculated. Univariate analysis, stepwise logistic regression analysis and receiver operating characteristic curves (ROC) were performed.

The mean age was 61.3 years (range 45 to 78 years). There were 11 females and 35 males, who had 22 well-differentiated (WD HCC), 35 moderately-differentiated (MD HCC), and 16 poorly differentiated (PD HCC) lesions. On visual analysis of the hepatocellular phase, a hyperintense or isointense lesion was likely to be WD HCC (sensitivity 45%, specificity 76%). On quantitative analysis, the only significant predictor of the grade of HCC was the ER on the hepatocellular phase (p=0.019 and 0.001 for the two reviewers in logistic regression model). On ROC analysis, an ER of > 13% was 47% sensitive and 89% specific in predicting WD HCC histology.

The hepatocellular phase of gadobenate may help to differentiate some cases of WD HCC from the more aggressive grades, though there is overlap between the different grades on qualitative and quantitative analysis.

The hepatocellular phase may have some use in differentiating WD-HCC from higher grades if biopsy is indeterminate or not practical.

Sandrasegaran, K, Ramaswamy, R, Bertrand, K, Tahir, B, Akisik, F, Saxena, R, Does the Hepatocellular Phase of Gadobenate Help to Differentiate Hepatocellular Cancer in Cirrhotic Patients According to Histological Grade?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9005826.html