title: Comparison of gadoxetic acid-enhanced magnetic resonance imaging and contrast-enhanced computed tomography with histopathological examinations for the identification of hepatocellular carcinoma: a multicenter phase III study.
abstract: BACKGROUND
  Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has an important role in preoperative evaluation of hepatocellular carcinoma (HCC). However, no studies have prospectively performed intraindividual comparison of gadoxetic acid-enhanced 3T MRI and multidetector-row computed tomography (MDCT) with histopathological examination for the detection of HCCs. We prospectively compared the efficacies of gadoxetic acid-enhanced MRI and multiphasic contrast-enhanced MDCT with that of histopathological examination, used as a reference standard, for the detection of HCC in surgical candidates.
  
  
  METHODS
  The study was approved by the institutional review boards at each of four centers. Patients scheduled to undergo multiphasic CT, gadoxetic acid-enhanced MRI, and liver surgery were prospectively included in this study. The diagnostic abilities of MRI and CT were evaluated and compared on the basis of sensitivity and positive predictive value for detection of and differentiation between HCCs and benign lesions.
  
  
  RESULTS
  Fifty-four patients with 83 histopathologically confirmed HCCs were included in the study. Combined interpretation of the dynamic and hepatobiliary phases of gadoxetic acid-enhanced MRI showed statistically higher sensitivity for lesion detection (83 %) than did interpretation of multiphasic MDCT images (70 %; p < 0.001). The mean area under each alternative free-response receiver operating characteristics curve was significantly higher for MR images (0.927) than for CT images (0.864, p < 0.01).
  
  
  CONCLUSIONS
  The sensitivity for preoperative detection of HCCs was higher for gadoxetic acid-enhanced MRI than for multiphasic MDCT imaging.
authors.affiliation: Faculty of Medicine-Radiology, Kinki University, Osakasayama, Osaka, Japan. mtsuru@dk2.so-net.ne.jp.
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Tsurusaki
authors.affiliation: National Cancer Center Hospital-Diagnostic Radiology, 5-1-1, Tsukiji, Chuo-ku, Tokyo, Tokyo, 104-0045, Japan.|Kobe University Graduate School of Medicine-Radiology, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Sofue
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Isoda
authors.affiliation: Faculty of Medicine-Radiology, Kinki University, Osakasayama, Osaka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okada
authors.affiliation: Kobe University Graduate School of Medicine-Radiology, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.|Department of Raiology, Dokkyo Medical School, Mibu, Tochigi, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kitajima
authors.affiliation: Faculty of Medicine-Radiology, Kinki University, Osakasayama, Osaka, Japan.
authors.forename: Takamichi
authors.initials: T
authors.lastname: Murakami
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D003951:Diagnostic Errors; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D015588:Observer Variation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: CT; Diagnosis; Gadoxetic acid; Hepatocellular carcinoma; MRI