Prediction of macroscopic findings of hepatocellular carcinoma on hepatobiliary phase of gadolinium‐ethoxybenzyl‐diethylenetriamine pentaacetic acid‐enhanced magnetic resonance imaging: Correlation with pathology

Aim We aimed to correlate the macroscopic and magnetic resonance imaging ( MRI ) findings of hepatocellular carcinomas ( HCC ). Methods This was a multicenter study, whose study protocol was approved by each institutional review board. One hundred and forty‐six resected nodules in 124 patients who had received a preoperative hepatobiliary phase of gadolinium‐ethoxybenzyl‐diethylenetriamine pentaacetic acid‐enhanced MRI ( EOB ‐ MRI ) were analyzed. In both findings, we compared the diameter of HCC and macroscopic types divided into five types: (i) small nodular type with indistinct margin ( SN ‐ IM ); (ii) simple nodular type (with distinct margin) ( SN ‐ DM ); (iii) simple nodular type with extranodular growth ( SN ‐ EG ); (iv) confluent multinodular type ( CMN ); and (v) infiltrative type ( IF ). Results The diameters in each finding ( D surg and D MRI ) were significantly correlated ( R  = 0.961), although D surg was larger than D MRI ( P  = 0.0216). There were significant differences between D surg in SN ‐ IM and the other groups ( P  < 0.0001). Sensitivity, specificity and accuracy were 5.3, 99.2 and 87; 84.8, 62.7 and 81.4; 58.1, 91.3 and 84.2; 70.6, 91.5 and 89, in SN ‐ IM , SN ‐ DM , SN ‐ EG and CMN , respectively. The kappa value of every size was as follows: all sizes, 0.45; 20 mm or less, 0.23; more than 20 mm, 0.56. Conclusion EOB ‐ MRI could predict the macroscopic pathological findings except for SN ‐ IM . Small tumor size might be helpful to diagnose SN ‐ IM .