title: Characterization of hyperintense nodules on precontrast T1-weighted MRI: utility of gadoxetic acid-enhanced hepatocyte-phase imaging.
abstract: OBJECTIVE
  To evaluate the utility of gadoxetic acid-enhanced hepatocyte-phase magnetic resonance imaging (MRI) in characterization of T1-weighted hyperintense nodules within cirrhotic liver.
  
  
  METHODS
  This retrospective study was approved by our Institutional Review Board. Thirty-four nodules hyperintense in unenhanced T1-weighted MRI with histopathological confirmation from a collection of 19 patients were included. Tumor size, signal intensity on T1-weighted, and T2-weighted imaging as well as enhancement patterns on contrast-enhanced dynamic/hepatocyte-phase imaging were recorded. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of hepatocyte-phase imaging.
  
  
  RESULTS
  Evaluation of the nodules with standard of reference revealed 15 dysplastic nodules (DN), seven well-differentiated hepatocellular carcinomas (wHCC), and 12 moderately differentiated HCCs (mHCC). The mean size of dysplastic nodules was smaller than that of HCCs (P < 0.001). Using the HCC criteria (T2W or arterial enhancement followed with portal venous washout), 11/19 HCC were correctly characterized. Using solely hypointensity (compared to the surrounding liver parenchyma) during the hepatocyte phase as the criterion, 18/19 HCC were correctly characterized. There were seven additional HCCs diagnosed with hepatocyte-phase imaging (P = 0.02).
  
  
  CONCLUSIONS
  Gadoxetic acid-enhanced MRI with hepatocyte-phase imaging is superior to gadoxetic acid-enhanced MRI with conventional criteria alone in characterization of T1W hyperintense nodules.
authors.affiliation: Department of Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taipei, Taiwan.
authors.forename: Chen-Te
authors.initials: CT
authors.lastname: Chou
authors.forename: Yao-Li
authors.initials: YL
authors.lastname: Chen
authors.forename: Hwa-Koon
authors.initials: HK
authors.lastname: Wu
authors.forename: Ran-Chou
authors.initials: RC
authors.lastname: Chen
mesh_terms: D001706:Biopsy; D002454:Cell Differentiation; D003287:Contrast Media / Q000494:pharmacology; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D019786:Gadolinium DTPA / Q000494:pharmacology*; D022781:Hepatocytes / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA