title: Detection of hepatocellular carcinoma: combined T2-weighted and dynamic gadolinium-enhanced MRI versus combined CT during arterial portography and CT hepatic arteriography.
abstract: OBJECTIVE
  The purpose of this study was to compare the preoperative detectability of hepatocellular carcinomas (HCCs) using combined T2-weighted and dynamic gadolinium-enhanced MRI and combined CT during arterial portography (CTAP) and CT hepatic arteriography (CTHA).
  
  
  METHODS
  Thirty-three patients with 43 HCCs underwent T2-weighted and dynamic gadolinium-enhanced MRI and combined CTAP and CTHA. The diagnosis was established by pathologic examination following surgical resection in 26 patients and by biopsy in 7 patients. The MR protocol included fast SE with two TEs (including T2-weighted imaging) and precontrast and gadolinium-enhanced T1-weighted fast multiplanar spoiled gradient-recalled echo images with dynamic study. The MR images of all sequences and the paired CTAP and CTHA images were independently reviewed by three radiologists. Image review was conducted on a segment-by-segment basis. Diagnostic accuracy was evaluated with receiver operating characteristic analysis.
  
  
  RESULTS
  The accuracies (Az values) of MRI of all sequences and combined CTAP and CTHA for all observers were 0.960 and 0.959, respectively. The mean sensitivities of MRI and CT were 90 and 94%, respectively. The differences were not statistically significant. The mean specificity of MRI (99%) was significantly higher than that of combined CTAP and CTHA (92%).
  
  
  CONCLUSIONS
  Combined T2-weighted and dynamic gadolinium-enhanced MRI is as accurate as combined CTAP and CTHA for preoperative detection of HCCs.
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: D
authors.initials: D
authors.lastname: Choi
authors.forename: S H
authors.initials: SH
authors.lastname: Kim
authors.forename: J H
authors.initials: JH
authors.lastname: Lim
authors.forename: J M
authors.initials: JM
authors.lastname: Cho
authors.forename: W J
authors.initials: WJ
authors.lastname: Lee
authors.forename: S J
authors.initials: SJ
authors.lastname: Lee
authors.forename: H K
authors.initials: HK
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D005682:Gadolinium; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D005682:Gadolinium