Ke Wang MD, Presenter: Nothing to Disclose

Ze Peng, Abstract Co-Author: Nothing to Disclose

Xuedong Yang, Abstract Co-Author: Nothing to Disclose

Xiaoying Wang MD, Abstract Co-Author: Nothing to Disclose

To prospectively compare the diagnostic performance of multidetector computed tomographic (MDCT) imaging, unenhanced MRI (MR-) and unenhanced combined contrast-enhanced MRI (MR±) in the detection of small hepatocellular carcinoma (SHCC) in patients with cirrhosis induced by HBV infection.

A total of 150 patients (118M/32F; mean age, 54y; age range, 28-79y)confirmed with cirrhosis induced by HBV infection and suspected of SHCCs (≤3cm) underwent unenhanced combined contrast-enhanced MRIand multiphasic MDCT within 30days. The images were qualitatively analyzedby 3 independent readers in three separate reading sessions(CT, MR-, MR±). Using strict diagnostic criteria for HCC, readers classified all detected lesions with use of a five-point confidence scale. The reference standard was a combination of pathologic proof, interventional therapy results and substantial tumor growth at follow-up CT or MRI. Interreader variability was assessed. The diagnostic performance of these techniques for the detection of SHCC was assessed by receiver operating characteristic (ROC) analysis, in addition to evaluating the sensitivity, specificity, positive predictive value (PPV) and negative predict value (NPV).

A total of 164SHCCs (mean size± standard deviation, 1.8cm±0.6；range, 0.7- 3.0cm) were detected. For all the lesions, the area under the ROC curve (Az) was significantly higher withMR±(0.947) than either with MR- (0.856) or with MDCT (0.897) (P＜0.05 for both comparisons＝. The mean sensitivity and NPVof MR±(94.31%; 78.46%) were significantly higher than those of MR- (82.11%; 53.68%) and MDCT (85.57%; 58.24%)(P＜0.05 for both comparisons＝. The mean specificityand PPV were not significantly different among the three imaging sets. For lesionssmaller than 2cm, the results were similar.Interreader agreement was good.

Unenhanced combined contrast-enhanced MR imaging shows a better diagnostic performance for the detection of small HCCs (both for lesions ≤3cm and lesions ≤2cm) compared with either unenhanced MR or multiphasic MDCT in patients with cirrhosis induced by HBV infection.

Unenhanced combined contrast-enhanced MR imaging is better than either unenhanced MR or multiphasic MDCT in detecting small HCCs, and is recommended in the evaluation of suspected HCC in patients with cirrhosis induced by HBV infection.

Wang, K, Peng, Z, Yang, X, Wang, X, Prospective, Multicenter, Intra-individual Comparison of Multidetector CT and Contrast-enhanced MR Imaging in the Detection of Small Hepatocellular Carcinoma in Patients with Cirrhosis Induced by HBV Infection.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010268.html