title: Gadoxetate Disodium-Enhanced MRI to Differentiate Dysplastic Nodules and Grade of Hepatocellular Carcinoma: Correlation With Histopathology.
abstract: OBJECTIVE
  The objective of our study was to determine quantitative differences to differentiate low-grade from high-grade dysplastic nodules (DNs) and low-grade from high-grade hepatocellular carcinomas (HCCs) using gadoxetate disodium-enhanced MRI.
  
  
  METHODS
  A retrospective study of 149 hepatic nodules in 127 consecutive patients who underwent gadoxetic acid-enhanced MRI was performed. MRI signal intensities (SIs) of the representative lesion ROI and of ROIs in liver parenchyma adjacent to the lesion were measured on unenhanced T1-weighted imaging and on dynamic contrast-enhanced MRI in the arterial, portal venous, delayed, and hepatobiliary phases. The relative SI of the lesion was calculated for each phase as the relative intensity ratio as follows: [mass SI / liver SI].
  
  
  RESULTS
  Of the 149 liver lesions, nine (6.0%) were low-grade DNs, 21 (14.1%) were high-grade DNs, 83 (55.7%) were low-grade HCCs, and 36 (24.2%) were high-grade HCCs. The optimal cutoffs for differentiating low-grade DNs from high-grade DNs and HCCs were an unenhanced to arterial SI of ≥ 0 or a relative SI on T2-weighted imaging of ≤ 1.5, with a positive predictive value (PPV) of 99.2% and accuracy of 88.6%. The optimal cutoffs for differentiating low-grade HCCs from high-grade HCCs were a relative hepatobiliary SI of ≤ 0.5 or a relative T2 SI of ≥ 1.5, with a PPV of 81.0% and an accuracy of 60.5%.
  
  
  CONCLUSIONS
  Gadoxetate disodium-enhanced MRI allows quantitative differentiation of low-grade DNs from high-grade DNs and HCCs, but significant overlap was seen between low-grade HCCs and high-grade HCCs.
authors: 1 Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Ste 1638, Los Angeles, CA 90095.
authors: Stephanie
authors: S
authors: Channual
authors: 1 Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Ste 1638, Los Angeles, CA 90095.
authors: Nelly
authors: N
authors: Tan
authors: 2 Department of Radiology, Chalubhorn Hospital, Bangkok, Thailand.
authors: Surachate
authors: S
authors: Siripongsakun
authors: 3 Department of Pathology and Laboratory Medicine, Anatomic Pathology & Clinical Pathology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors: Charles
authors: C
authors: Lassman
authors: 1 Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Ste 1638, Los Angeles, CA 90095.
authors: David S
authors: DS
authors: Lu
authors: 1 Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Ste 1638, Los Angeles, CA 90095.
authors: Steven S
authors: SS
authors: Raman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: dysplastic nodule; gadoxetate disodium; hepatocellular carcinoma