title: [Evaluation of noninvasive diagnostic criteria for hepatocellular carcinoma on pretransplant MRI (2010): correlation between MR imaging features and histological features on liver specimen].
abstract: OBJECTIVE
  To validate the 2010 diagnostic criteria from the American Association for the Study of Liver Diseases (AASLD) for hepatocellular carcinoma (HCC) on MRI using the surgical liver specimen as a gold standard.
  
  
  METHODS
  A total of 21 liver transplant recipients were retrospectively included. Each underwent surgery because of HCC between January 2007 and January 2008. Pre-transplant MRI was performed on a 1.5 Tesla MR unit. The T1W and T2W signal and kinetic contrast enhancement were correlated for each lesion with the surgical specimen. Lesion diameters between MRI and specimen were compared (Spearman). A multivariate model was created (R statistics software package) to predict the presence and grade of tumor differentiation (WHO, Edmonson Steiner).
  
  
  RESULTS
  A total of 71 nodules were detected at histology, including 54 HCC (mean size: 25.3mm) compared to 68 on MRI. There was moderate agreement (r=0.58, P<0.001) between the maximum lesion diameters measured on MRI and at histology. Wash-out on MRI provided an accuracy of 75 % for the detection of HCC (sensitivity=75 %, specificity=76 %). Adding T2W hyperintensity to the AASLD criteria increased the sensitivity of MRI from 70.3 % to 77.7 % for the diagnosis of HCC and from 67.6 % to 79 % for nodules less than 20mm in diameter, without affecting specificity. On multivariate analysis, wash out as a single variable was significantly associated with a diagnosis of HCC (P<0.01, odds ratio 12.0, CI 95 % [2.6-55.5]). T1W hyperintensity (P=0.04, odds ratio 5.4) and loss of signal on opposed-phase images (P=0.02, odds ratio 9.2) were predictive of good differentiation.
  
  
  CONCLUSIONS
  On MRI, the AASLD criteria or presence of wash out within a liver nodule in patients with underlying chronic hepatocellular disease are suggestive of tumoral transformation. The addition of T2W hyperintensity to the AASLD criteria increases the detection of HCC, especially nodules smaller than 20mm.
authors.affiliation: Service d'imagerie médicale, groupe Henri-Mondor-Albert-Chenevier, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
authors.forename: W
authors.initials: W
authors.lastname: Ouedraogo
authors.forename: J
authors.initials: J
authors.lastname: Tran-Van Nhieu
authors.forename: L
authors.initials: L
authors.lastname: Baranes
authors.forename: S-J
authors.initials: SJ
authors.lastname: Lin
authors.forename: T
authors.initials: T
authors.lastname: Decaens
authors.forename: A
authors.initials: A
authors.lastname: Laurent
authors.forename: M
authors.initials: M
authors.lastname: Djabbari
authors.forename: F
authors.initials: F
authors.lastname: Pigneur
authors.forename: C
authors.initials: C
authors.lastname: Duvoux
authors.forename: H
authors.initials: H
authors.lastname: Kobeiter
authors.forename: J-F
authors.initials: JF
authors.lastname: Deux
authors.forename: A
authors.initials: A
authors.lastname: Rahmouni
authors.forename: A
authors.initials: A
authors.lastname: Luciani
mesh_terms: D000368:Aged; D000465:Algorithms; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005602:France; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012955:Societies, Medical; D013223:Statistics as Topic; D047368:Tumor Burden
chemical_list: D003287:Contrast Media