title: Computer-assisted evaluation of contrast kinetics for detection of hepatocellular carcinoma on magnetic resonance imaging.
abstract: The purpose of this study was to assess the use of semiquantitative contrast-enhanced parameter analysis as an objective criteria for improving the magnetic resonance (MR) evaluation of hepatocellular carcinoma (HCC) in patients with cirrhosis. Contrast-enhanced MR examination findings from 19 patients with 21 pathologically proven HCC were evaluated using a dedicated liver image postprocessing workstation. Contrast-enhancement kinetic curves were created for each lesion, and 4 enhancement parameters (arterial wash-in slope, arterial-portal slope, arterial-equilibrium slope, and portal-equilibrium slope) were defined from the signal intensity-time plots. The accuracy of each enhancement parameter for the characterization of HCC was assessed. Statistical analysis revealed that an arterial-phase wash-in slope percentage value >1.35 per sec had a sensitivity of 86%, a specificity of 71%, and an accuracy of 79% for the correct characterization of HCC, whereas an arterial-equilibrium wash-out slope percentage value<0.05 per sec had a sensitivity of 86%, a specificity of 81%, and an accuracy of 83%. Although there were significant differences among all groups, the greatest accuracy for differentiation based on receiver operating curve analysis appears to be with arterial and arterial-equilibrium phases. Semiquantitative analysis of lesion contrast kinetics could provide objective parameters to improve the characterization of HCC on contrast-enhanced MR images.
authors.affiliation: Department of Radiology, University of Rochester Medical Center, Rochester, NY.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Chaturvedi
authors.affiliation: Department of Radiology, University of Washington, VA Puget Sound Health Care System, Seattle, WA. Electronic address: bhargp@uw.edu.
authors.forename: Puneet
authors.initials: P
authors.lastname: Bhargava
authors.affiliation: Department of Radiology, University of Washington, Seattle, WA.
authors.forename: Orpheus
authors.initials: O
authors.lastname: Kolokythas
authors.affiliation: Department of Radiology, University of Washington, Seattle, WA.
authors.forename: Lee M
authors.initials: LM
authors.lastname: Mitsumori
authors.affiliation: Department of Radiology, University of Washington, Seattle, WA.
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Maki
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008099:Liver / Q000033:anatomy & histology / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA