Gadoxetic acid-enhanced MRI versus triple-phase MDCT for the preoperative detection of hepatocellular carcinoma.
OBJECTIVE
We compared the diagnostic performance of gadoxetic acid-enhanced MRI with that of triple-phase 16-, 40-, and 64-MDCT in the preoperative detection of hepatocellular carcinoma (HCC).


METHODS
Sixty-two consecutively registered patients (54 men, eight women; age range, 31-67 years) with 83 HCCs underwent triple-phase (arterial, portal venous, equilibrium) CT at 16-, 40-, or 64-MDCT and gadoxetic acid-enhanced 3-T MRI. The diagnosis of HCC was established after surgical resection. Three observers independently and randomly reviewed the MR and CT images on a tumor-by-tumor basis. The diagnostic accuracy of these techniques in the detection of HCC was assessed with alternative free response receiver operating characteristic (ROC) analysis. Sensitivity, positive and negative predictive values, and sensitivity according to tumor size were evaluated.


RESULTS
For each observer, the areas under the ROC curve were 0.971, 0.959, and 0.967 for MRI and 0.947, 0.950, and 0.943 for CT. The differences were not statistically significant between the two techniques for each observer (p > 0.05). The differences in sensitivity and positive and negative predictive values between the two techniques for each observer were not statistically significant (p > 0.05). Among 10 HCCs 1 cm in diameter or smaller, each of the observers detected seven tumors with MRI. With CT, one observer detected five, one observer detected four, and one observer detected three HCCs with no statistically significant difference (p > 0.05).


CONCLUSIONS
Gadoxetic acid-enhanced MRI and triple-phase MDCT have similar diagnostic performance in the preoperative detection of HCC, but MRI may be better than MDCT in the detection of HCC 1 cm in diameter or smaller.
Kim
Seong Hyun
SH
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kim
Seung Hoon
SH
Lee
Jongmee
J
Kim
Min Ju
MJ
Jeon
Yong Hwan
YH
Park
Yulri
Y
Choi
Dongil
D
Lee
Won Jae
WJ
Lim
Hyo K
HK
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000601:surgery*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA