title: Gadoxetic acid-enhanced MRI compared with CT during angiography in the diagnosis of hepatocellular carcinoma.
abstract: OBJECTIVE
  To assess the value of gadoxetic acid-enhanced magnetic resonance imaging (MRI) for the pre-therapeutic detection of hepatocellular carcinoma (HCC) using receiver operating characteristic (ROC) analysis with the combination of computed tomography (CT) arterial portography and CT hepatic arteriography (CTAP/CTHA).
  
  
  METHODS
  A total of 54 consecutive patients with 87 nodular HCCs were retrospectively analyzed. All HCC nodules were confirmed pathologically. Three blinded readers independently reviewed 432 hepatic segments, including 78 segments with 87 HCCs. Each reader read two sets of images: Set 1, CTAP/CTHA; Set 2, gadoxetic acid-enhanced MRI including a gradient dual-echo sequence and diffusion-weighted imaging (DWI). The ROC method was used to analyze the results. The sensitivity, specificity, positive predictive value, negative predictive value and sensitivity according to tumor size were evaluated.
  
  
  RESULTS
  For each reader, the area under the curve was significantly higher for Set 2 than for Set 1. The mean area under the curve was also significantly greater for Set 2 than for Set 1 (area under the curve, 0.98 vs. 0.93; P=.0009). The sensitivity was significantly higher for Set 2 than for Set 1 for all three readers (P=.012, .013 and .039, respectively). The difference in the specificity, positive predictive values and negative predictive values of the two modalities for each reader was not significant (P>.05).
  
  
  CONCLUSIONS
  Gadoxetic acid-enhanced MRI including a gradient dual-echo sequence and DWI is recommended for the pre-therapeutic evaluation of patients with HCC.
authors.affiliation: Department of Medicine and Clinical Oncology, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. ooka-y@umin.ac.jp
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ooka
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kanai
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Okabe
authors.forename: Takuya
authors.initials: T
authors.lastname: Ueda
authors.forename: Ryota
authors.initials: R
authors.lastname: Shimofusa
authors.forename: Sadahisa
authors.initials: S
authors.lastname: Ogasawara
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Chiba
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Sato
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA