title: Hepatocellular carcinoma missed on gadolinium enhanced MR imaging, discovered in liver explants: retrospective evaluation.
abstract: The main purpose of this study was to determine if hepatocellular carcinomas (HCCs) missed on prospective magnetic resonance (MR) study could be identified on retrospective MR analysis, and to determine the cause for misdiagnosis. Among 555 patients who underwent liver transplantation between 1993 and 2004, 279 were imaged with MR imaging and four of these revealed HCCs in explanted livers that were not reported on prospective MR reading. The main cause of missed lesions were suboptimal image quality due to inability of patients to suspend respiration; other causes were HCC misinterpreted as high-grade dysplastic nodule and isoenhancement of HCC on early phase images.
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, North Carolina 27599-7510, USA.
authors.forename: Mirace Y
authors.initials: MY
authors.lastname: Karadeniz-Bilgili
authors.forename: Larissa
authors.initials: L
authors.lastname: Braga
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Birchard
authors.forename: David
authors.initials: D
authors.lastname: Gerber
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Firat
authors.forename: John T
authors.initials: JT
authors.lastname: Woosley
authors.forename: Roshan
authors.initials: R
authors.lastname: Shrestha
authors.forename: Richard C
authors.initials: RC
authors.lastname: Semelka
mesh_terms: D000328:Adult; D000368:Aged; D016477:Artifacts; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D003951:Diagnostic Errors; D005188:False Negative Reactions; D005260:Female; D005682:Gadolinium; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D005682:Gadolinium