title: Efficacy of fusion imaging combining sonography and hepatobiliary phase MRI with Gd-EOB-DTPA to detect small hepatocellular carcinoma.
abstract: OBJECTIVE
  We evaluated the efficacy of fusion imaging that fuses conventional sonography images with hepatobiliary phase contrast-enhanced MR images obtained with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) as the reference image for the detection of hepatocellular carcinomas (HCCs).
  
  
  METHODS
  Eighty-seven HCCs with a maximum diameter of between 1 and 3 cm at the time of diagnosis were enrolled in this prospective study. We compared the detection rates of HCCs using three sonography modalities: conventional sonography, late phase of contrast-enhanced sonography with Sonazoid, and fusion imaging combining conventional sonography and the hepatobiliary phase of contrast-enhanced MRI with Gd-EOB-DTPA as the reference image. The comparisons were made using the McNemar test.
  
  
  RESULTS
  The detection rate of HCCs using fusion imaging (98%, 85/87) was significantly higher than the detection rates using conventional sonography (76%, 66/87) and contrast-enhanced sonography (83%, 72/87) (p<0.01, for both). For small HCCs (maximum diameter, 1-2 cm), the detection rate using fusion imaging (97%, 59/61) was also significantly higher than those using conventional sonography (66%, 40/61) and contrast-enhanced sonography (80%, 49/61) (p<0.01, for both). The detection rate for atypical HCCs was also significantly higher using fusion imaging (95%, 18/19) than using conventional sonography (53%, 10/19) and contrast-enhanced sonography (26%, 5/19) (p<0.01, for both).
  
  
  CONCLUSIONS
  Fusion imaging combining conventional sonography and the hepatobiliary phase of contrast-enhanced MRI with Gd-EOB-DTPA is more sensitive than conventional sonography or contrast-enhanced sonography for detecting HCCs, especially small or atypical HCCs.
authors.affiliation: Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kunishi
authors.forename: Kazushi
authors.initials: K
authors.lastname: Numata
authors.forename: Manabu
authors.initials: M
authors.lastname: Morimoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okada
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Kaneko
authors.forename: Shin
authors.initials: S
authors.lastname: Maeda
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D005290:Ferric Compounds; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted; D007501:Iron; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010087:Oxides; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; D010087:Oxides; C069727:Sonazoid; C073590:gadolinium ethoxybenzyl DTPA; D007501:Iron; D019786:Gadolinium DTPA