Premium
Detection of small hepatocellular carcinoma using gadoxetic acid‐enhanced MRI : Is the addition of diffusion‐weighted MRI at 3.0 T beneficial?
Author(s) -
Zhao Xiang Tian,
Li Wei Xia,
Chai Wei Min,
Chen Ke Min
Publication year - 2014
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12119
Subject(s) - gadoxetic acid , hepatocellular carcinoma , medicine , diffusion mri , magnetic resonance imaging , radiology , gadolinium dtpa , nuclear medicine , nuclear magnetic resonance , physics
Objective To determine whether adding diffusion‐weighted imaging ( DWI ) to gadoxetic acid‐enhanced 3.0 T magnetic resonance imaging ( MRI ) can improve the detection of hepatocellular carcinoma ( HCC ), particularly for small lesions (≤2 cm) in patients with liver cirrhosis. Methods Data of patients diagnosed with focal liver lesions who had undergone gadoxetic acid‐enhanced 3.0 T MRI and DWI were retrospectively reviewed. Two radiologists (the observers) reviewed independently MRI images in two reading sessions, that is, gadoxetic acid‐enhanced images alone and the combination of DWI (b values: 0 and 600 s/mm 2 ) and gadoxetic acid‐enhanced images. They assigned to each lesion a confidence level based on a five‐point scale. The area under the receiver operating characteristic curve ( AUROC ), sensitivity and positive predictive value ( PPV ) for the detection of HCC were calculated. Results Both observers found the AUROC of the gadoxetic acid‐enhanced images was slightly higher than that of the combined DWI and gadoxetic acid‐enhanced MRI images in the detection of HCC (observer 1: 0.947 ± 0.030 vs 0.896 ± 0.042, Z = 1.478, P = 0.139; observer 2: 0.917 ± 0.038 vs 0.868 ± 0.048, Z = 1.296, P = 0.195). The sensitivity for the gadoxetic acid set alone was slightly higher than that for the combined set for observer 1 (97% vs 84%) and slightly lower for observer 2 (74% vs 82%). The PPVs were slightly higher for the gadoxetic acid set alone than for the combined set for both observers (observer 1, 89% vs 80%; observer 2, 93% vs 78%); however, none of the differences were statistically significant ( P > 0.05). Conclusion There is no benefit in adding DWI to gadoxetic acid‐enhanced MRI for the detection of HCC at 3.0 T .