Detection of hepatocellular carcinoma: gadoxetic acid-enhanced 3-dimensional magnetic resonance imaging versus multi-detector row computed tomography.
OBJECTIVE
The aim of this study was to compare the diagnostic accuracy and sensitivity of gadoxetic acid-enhanced magnetic resonance imaging (MRI) with multi-detector row computed tomography (MDCT) for the detection of hepatocellular carcinomas (HCCs).


METHODS
Sixty-two patients (81 HCCs) who underwent MDCT and gadoxetic acid-enhanced MRI using a 3-dimensional volumetric interpolated technique with a mean interval of 7 days (range, 3-11 days) were included in this study. Two observers reached a consensus on 2 sets of images: the gadoxetic acid set (unenhanced, early dynamic, 10-minute, and 20-minute hepatocyte phase images) and the 3-phase MDCT. Diagnostic accuracy and sensitivity were evaluated using the alternative-free response receiver operating characteristic method.


RESULTS
There was a trend toward increased area under the receiver operating characteristic curve (Az value) for the gadoxetic acid set (0.963) as compared with the MDCT (0.930), but no significant difference was found (P = 0.41). Sensitivity of the gadoxetic acid set (91.4%) was better than that of the MDCT (71.6%; P = 0.0001). There were 12 lesions that showed only arterial hypervascularization on MDCT but showed arterial hypervascularization and delayed hypointensity on the gadoxetic acid set.


CONCLUSIONS
Gadoxetic acid-enhanced MRI, including hepatocyte phase imaging, is more sensitive than MDCT for the detection of HCCs.
Kim
Young Kon
YK
Department of Diagnostic Radiology, Medical School, Chonbuk National University Hospital, JeonJu, Republic of Korea. jmyr@dreamwiz.com
Kim
Chong Soo
CS
Han
Young Min
YM
Kwak
Hyo Sung
HS
Jin
Gong Yong
GY
Hwang
Seung Bae
SB
Chung
Gyung Ho
GH
Lee
Sang Yong
SY
Yu
Hee Chul
HC
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA