title: Gadoxetic acid-enhanced MRI for T-staging of gallbladder carcinoma: emphasis on liver invasion.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of gadoxetic acid-enhanced MRI with an emphasis on the usefulness of the hepatobiliary phase (HBP) in T-staging of gallbladder carcinoma.
  
  
  METHODS
  66 patients with surgically confirmed gallbladder carcinoma underwent MRI. Two radiologists independently reviewed two sets of gadoxetic acid-enhanced MRI without and with the HBP. Local tumour spread was evaluated according to T-staging, and the results were compared with pathological findings. The diagnostic performance of two image sets to differentiate each T-stage was compared.
  
  
  RESULTS
  The sensitivities of MRI with the HBP to differentiate T1 vs ≥ T2 lesions, ≤ T2 vs ≥ T3 lesions and ≤ T3 vs T4 lesions were 96.3%, 85.7% and 100% for Observer 1 and 92.6%, 95.2% and 100% for Observer 2, respectively (p<0.0001). By adding the HBP, the sensitivities to differentiate ≤ T2 vs ≥ T3 lesions were increased from 66.7% to 85.7% for Observer 1 and from 81.0% to 95.2% for Observer 2, although there was no significant difference (p>0.05). The overall accuracies for T-staging were increased from 80.3% to 86.4% for Observer 1, a statistically significant degree (p=0.046), and from 83.8% to 87.9% for Observer 2 (p>0.05). The k-value for the two observers indicated excellent agreement.
  
  
  CONCLUSIONS
  Gadoxetic acid-enhanced MRI provided acceptable diagnostic performance for T-staging of gallbladder carcinoma. Addition of the HBP aids in the detection of liver invasion.
  
  
  CONCLUSIONS
  In the T-staging of gallbladder carcinoma, gadoxetic acid-enhanced MRI with the HBP may enhance detection of liver invasion.
authors.affiliation: Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
authors.forename: J
authors.initials: J
authors.lastname: Hwang
authors.forename: Y K
authors.initials: YK
authors.lastname: Kim
authors.forename: D
authors.initials: D
authors.lastname: Choi
authors.forename: H
authors.initials: H
authors.lastname: Rhim
authors.forename: W J
authors.initials: WJ
authors.lastname: Lee
authors.forename: S S
authors.initials: SS
authors.lastname: Hong
authors.forename: H-J
authors.initials: HJ
authors.lastname: Kim
authors.forename: Y-W
authors.initials: YW
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D005706:Gallbladder Neoplasms / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008113:Liver Neoplasms / Q000473:pathology* / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA