title: Utility of adding Primovist magnetic resonance imaging to analysis of hepatocellular carcinoma by liver dynamic computed tomography.
abstract: OBJECTIVE
  More information is needed on use of Primovist-enhanced magnetic resonance imaging (MRI) during initial staging analysis of patients with hepatocellular carcinoma (HCC) who are candidates for treatment with liver dynamic computed tomography (CT).
  
  
  METHODS
  We studied 104 patients who were initially diagnosed as Barcelona Clinic Liver Cancer (BCLC) stage 0 or A, without any other suspicious intrahepatic lesions, by liver dynamic CT from December 2009 to May 2012 at Inha University Hospital in Korea. We evaluated whether an addition of Primovist-enhanced MRI examination affected determination of BCLC stage, compared with liver dynamic CT.
  
  
  RESULTS
  On the basis of CT analysis, the median tumor size was 2.3 cm, and 98 patients had HCCs that met the Milan criteria (94.2%). All 104 patients (100%) had nodular type HCC. Abnormal intrahepatic findings were detected by Primovist-enhanced MRI in 41 patients (39.4%). Eighteen patients (17.3%) had new HCCs, but 6 patients who were initially of BCLC stage A remained at this stage, despite increases in tumor numbers. Of the 104 patients, 31 (29.8%) and 73 (70.2%) had BCLC stage 0 and A HCC before Primovist-enhanced MRI, respectively, and 26 (25.0%), 71 (68.3%), and 7 (6.7%) patients had BCLC stages 0, A, and B HCC after Primovist-enhanced MRI, respectively. In 12 of the 104 patients (11.5%), BCLC stage changed from 0 to A (5/31, 16.1%) or from A to B (7/73, 9.6%).
  
  
  CONCLUSIONS
  Primovist-enhanced MRI can provide additional information that can lead to the detection of new intrahepatic HCC lesions during initial staging analyses of patients with BCLC stage 0 or A HCC by liver dynamic CT, despite the absence of other suspicious liver lesions.
authors.affiliation: Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Jin
authors.forename: So-Yun
authors.initials: SY
authors.lastname: Nah
authors.forename: Jin-Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: Jung-Il
authors.initials: JI
authors.lastname: Lee
authors.forename: Seok
authors.initials: S
authors.lastname: Jeong
authors.forename: Don Haeng
authors.initials: DH
authors.lastname: Lee
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Soon Gu
authors.initials: SG
authors.lastname: Cho
authors.forename: Yong Sun
authors.initials: YS
authors.lastname: Jeon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA