Added diagnostic value of T2-weighted MR imaging to gadolinium-enhanced three-dimensional dynamic MR imaging for the detection of small hepatocellular carcinomas.
OBJECTIVE
To assess the added value of T2-weighted MRI to gadolinium-enhanced dynamic MRI for detection of HCCs.


METHODS
Two readers retrospectively analyzed MRIs of 115 patients with 131 HCCs (size; 0.6-2.0 cm) that had been diagnosed by histology (n=41) or imaging findings (n=90). Two separate blind image analyses of the gadolinium set and the combined T2-weighted imaging and gadolinium sets were performed. Diagnostic accuracy was evaluated using the alternative-free response receiver operating characteristic method with four-point scale. Sensitivity and positive predictive value were also calculated.


RESULTS
For both observers, the Az values and sensitivities with the combined T2-weighed imaging and gadolinium set (mean Az 0.806, sensitivity 84.7) were significantly higher than those with the gadolinium set (mean Az 0.660, sensitivity 59.9) (p<0.05). The addition of T2-weighted imaging led to a change in diagnosis for 27 lesions by both observers, which at gadolinium set were assigned a confidence level of 1 or 2 but at additional reading of T2-weighted imaging were assigned a confidence level of 3 or 4. For the positive predictive values, each image set showed a similar value for each observer.


CONCLUSIONS
The addition of T2-weighted imaging to gadolinium-enhanced 3D dynamic imaging could be helpful in the detection of HCC by increasing reader confidence for HCCs with equivocal findings on gadolinium-enhanced MRIs.
Kim
Young Kon
YK
Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, South Korea. Electronic address: jmyr@dreamwiz.com.
Lee
Young Hwan
YH
Department of Diagnostic Radiology, WonKwang University Hospital and School of Medicine, South Korea.
Kim
Chong Soo
CS
Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, South Korea.
Han
Young Min
YM
Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, South Korea.
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine