title: Added diagnostic value of T2-weighted MR imaging to gadolinium-enhanced three-dimensional dynamic MR imaging for the detection of small hepatocellular carcinomas.
abstract: 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.
authors: Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, South Korea. Electronic address: jmyr@dreamwiz.com.
authors: Young Kon
authors: YK
authors: Kim
authors: Department of Diagnostic Radiology, WonKwang University Hospital and School of Medicine, South Korea.
authors: Young Hwan
authors: YH
authors: Lee
authors: Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, South Korea.
authors: Chong Soo
authors: CS
authors: Kim
authors: Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, South Korea.
authors: Young Min
authors: YM
authors: Han
mesh_terms: 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
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine