title: Fate of hypointense lesions on Gd-EOB-DTPA-enhanced magnetic resonance imaging.
abstract: OBJECTIVE
  To investigate the natural outcome and clinical implication of hypointense lesions in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI.
  
  
  METHODS
  Forty patients underwent Gd-EOB-DTPA-enhanced MRI for preoperative evaluation of HCC. Hypointense lesions in the hepatobiliary phase that were hypovascular 5mm of more were extracted for follow-up. We performed a longitudinal study retrospectively for these lesions regardless of whether classical HCC developed or emerged in a different area from that of the lesions being followed.
  
  
  RESULTS
  Thirty one patients displayed 130 hypointense lesions on MRI and only nine showed no hypointense lesions. In total, 17 (13.1%) of 130 hypointense lesions on MRI developed into classical HCC. The cumulative rates for these lesions to develop into classical HCC were 3.2% at 1 year, 11.1% at 2 years and 15.9% at 3 years. The total occurrence rates of classical HCC (25.8% at 1 year, 52.6% at 2 years and 76.4% at 3 years) were higher compared to those regarding only occurrence of classical HCC from hypointense lesions on MRI (10.0% at 1 year, 35.6% at 2 years and 44.6% at 3 years), although no significant difference was observed (p=0.073).
  
  
  CONCLUSIONS
  Hypointense lesions that are detected in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI have some malignant potential, although treating these lesions aggressively in patients who already have HCC may be too severe.
authors.affiliation: Department of Radiology, Graduate School of Medicine, University of Tokyo, and Department of Radiological Technology, The University of Tokyo Hospital, Tokyo 113-8655, Japan. hakai-tky@umin.ac.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Akai
authors.forename: Izuru
authors.initials: I
authors.lastname: Matsuda
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kiryu
authors.forename: Taku
authors.initials: T
authors.lastname: Tajima
authors.forename: Hidemasa
authors.initials: H
authors.lastname: Takao
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Masaaki
authors.initials: M
authors.lastname: Akahane
authors.forename: Kuni
authors.initials: K
authors.lastname: Ohtomo
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA