Sang Hyun Choi, Presenter: Nothing to Disclose

Jae Ho Byun MD, Abstract Co-Author: Nothing to Disclose

Heon-Ju Kwon MD, Abstract Co-Author: Nothing to Disclose

Hong-Il Ha MD, Abstract Co-Author: Nothing to Disclose

So Jung Lee, Abstract Co-Author: Nothing to Disclose

Hyung Jin Won MD, Abstract Co-Author: Nothing to Disclose

Pyo Nyun Kim MD, Abstract Co-Author: Nothing to Disclose

To evaluate the usefulness of gadoxetic acid-enhanced dynamic magnetic resonance imaging (MRI) in staging hepatocellular carcinoma (HCC).

Two investigators independently and retrospectively reviewed dynamic computed tomography (CT) and gadoxetic acid-enhanced dynamic MRI obtained from July to September 2011 in 195 patients with HCC (158 men, 37 women; mean age, 57.1 years). The diagnostic performances of dynamic CT and MRI were evaluated. Barcelona Clinic Liver Cancer (BCLC) stages were determined before and after gadoxetic acid-enhanced dynamic MRI and according to final diagnosis. Change in BCLC stage was evaluated after adding gadoxetic acid-enhanced dynamic MRI to dynamic CT. The consistency between final BCLC stage and each of these two modalities was compared. Diagnostic performance and BCLC staging between gadoxetic acid-enhanced dynamic MRI and dynamic CT was compared using the McNemar test.

Final BCLC stage was classified as stage 0 (12.8%), A (60.5%), B (16.9%), C (8.7%), and D (1.0%), respectively. Gadoxetic acid-enhanced dynamic MRI showed significantly higher diagnostic performance than dynamic CT for HCC, including significantly greater sensitivity (observer 1, 90.6% [203/224] versus 79.5% [178/224]; observer 2, 88.4% [198/224] versus 63.8% [143/224]; P<.05), and significantly more accurate BCLC staging (observer 1, 92.8% [181/195] versus 80.5% [157/195]; observer 2, 89.2% [174/195] versus 68.2% [133/195]; P<.05). Gadoxetic acid-enhanced dynamic MRI showed higher interobserver agreement for the diagnosis (k = 0.630 versus 0.485) and staging (k = 0.851 versus 0.601) than dynamic CT. BCLC stage was changed correctly after gadoxetic acid-enhanced dynamic MRI in the patients showing differences between CT and final BCLC stages (observer 1, 71.1%; observer 2, 71.0%).

Gadoxetic acid-enhanced dynamic MRI provided important additional information compared with dynamic CT during initial staging HCC. Gadoxetic acid-enhanced dynamic MRI showed higher diagnostic performance and more accurate BCLC staging than dynamic CT.

Gadoxetic acid-enhanced dynamic MRI is important during initial staging HCC as it shows significantly more accurate BCLC staging and is more consistent with final BCLC stage than dynamic CT.

Choi, S, Byun, J, Kwon, H, Ha, H, Lee, S, Won, H, Kim, P, The Usefulness of Gadoxetic Acid-Enhanced Dynamic Magnetic Resonance Imaging in Hepatocellular Carcinoma: Toward Improved Staging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045640.html