Masakatsu Tsurusaki MD, PhD, Presenter: Nothing to Disclose

Keitaro Sofue, Abstract Co-Author: Nothing to Disclose

Hiroyoshi Isoda MD, Abstract Co-Author: Nothing to Disclose

Masahiro Okada MD, Abstract Co-Author: Nothing to Disclose

Yasukazu Shioyama, Abstract Co-Author: Nothing to Disclose

Hajime Kitagaki MD, Abstract Co-Author: Nothing to Disclose

Yasuaki Arai MD, Abstract Co-Author: Nothing to Disclose

Kazuro Sugimura MD, PhD, Abstract Co-Author: Research grant, Toshiba Corporation Research grant, Koninklijke Philips Electronics NV Research grant, Mitsubishi Corporation Research grant, Bayer AG Research grant, Eisai Co, Ltd Research grant, DAIICHI SANKYO Group Research Consultant, Shionogi & Co, Ltd

The purpose of this study was to prospectively evaluate the diagnostic performance of preoperative magnetic resonance (MR) imaging of the liver with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) in the detection of hepatocellular carcinoma (HCC) using 3.0 tesla (T) scanner.

Thirty patients were prospectively enrolled in this study at our institution. Institutional Review Board approval was obtained, and written informed consent was obtained from all patients. Twenty-eight with 48 histopathological confirmed HCCs underwent Gd-EOB-DTPA enhanced MR imaging using 3.0T scanner by surgery. Two patients were not performed surgery. The mean tumor size was 31.4 mm, ranging from 4 to 90mm, and including 11 tumors under 10mm in diameter. All MR studies were performed at a 3.0T scanner (Magnetom Trio, Siemens Medical Systems, Erlangen, Germany). MR examination consisted of T1-weighted 3dimensional-gradient echo (3D-GRE) dynamic sequences after bolus-injection of 0.025 mmol Gd-EOB-DTPA (Primovist; Bayer Schering Pharma, Osaka, Japan) and hepatocyte-phase after 20 minutes. Diagnostic analysis was performed by sensitivity and positive predictive value (PPV) for the detection of HCCs in arterial-phase images alone, hepatocyte-phase images alone, and combined arterial- and hepatocyte- phase images by 3 blinded readers. Sensitivity and PPV for the detection of HCCs at 3.0T were compared using McNemar test.

The mean sensitivity and PPV of all HCCs with hepatocyte-phase images alone (93.8, 91.8%, respectively) and combined arterial- and hepatocyte-phase images (93.8, 95.7%, respectively) were superior to that achieved with arterial-phase images alone (87.5, 87.5%, p < 0.05, respectively). The mean sensitivity and PPV of small HCCs (<10mm) with hepatocyte-phase images alone (72.7, 80.0%, respectively) were equal to combined arterial- and hepatocyte-phase images (72.7, 80.0%, respectively).

In this prospective study, preoperative Gd-EOB-DTPA-enhanced MR images at 3.0T including arterial-phase and hepatocyte-phase images have high sensitivity and PPV for the detection of HCCs, especially in hepatocyte-phase images were important for the detection of small HCCs.

Gd-EOB-DTPA-enhanced MR images at 3.0T including both arterial-phase and hepatocyte-phase images prospectively reveal high sensitivity and positive predictive value for the detection of HCC.

Tsurusaki, M, Sofue, K, Isoda, H, Okada, M, Shioyama, Y, Kitagaki, H, Arai, Y, Sugimura, K, Prospective Analysis of Preoperative Gd-EOB-DTPA-enhanced MR Imaging at 3.0 T in the Detection of Hepatocellular Carcinoma.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009520.html