title: Detection of Endogenous Iron Reduction during Hepatocarcinogenesis at Susceptibility-Weighted MR Imaging: Value for Characterization of Hepatocellular Carcinoma and Dysplastic Nodule in Cirrhotic Liver.
abstract: OBJECTIVE
  To investigate the value of susceptibility-weighted imaging (SWI) for characterization of hepatocellular carcinoma (HCC) and dysplastic nodule (DN).
  
  
  METHODS
  Sixty-eight cirrhotic patients with 89 hepatocellular nodules underwent SWI. The radiological features of hepatocellular nodules on SWI were classified into three types: type A (iso- or hypointensity, and background liver siderosis), type B (hyperintensity, and background liver siderosis), or type C (hyperintensity, and no background liver siderosis). Intranodular and background liver iron content was quantified and correlated with SWI pattern. Prussian blue staining was performed to quantify intranodular and background liver iron content.
  
  
  RESULTS
  Type A pattern (n = 12) contained 11 (91.7%) DNs and 1 (8.3%) HCC, Type B pattern (n = 66) comprised 1 (1.5%) DN and 65 (98.5%) HCCs (including 12 DN-HCCs and 53 overt HCCs), and type C pattern (n = 11) was exclusively seen in HCCs. The iron scores of DN-HCCs and overt HCCs were significantly lower than those of background livers [(0.091±0.30) VS (2.18±0.87), P = 0.000; (0.11±0.41) VS (2.16±0.97), P = 0.000; respectively]. There was no significant difference between iron scores of DNs and those of background livers [(1.92±0.29) VS (2.17±039), P = 0.191]. For lesion-based and patient-based analysis of HCCs (DN-HCCs and overt HCCs), type B pattern showed a sensitivity, specificity, accuracy, positive predicative value (PPV), and negative predicative value (NPV) of 84.4% and 84.4%, 91.7% and 75%, 85.4% and 83.8%, 98.5% and 98.2%, 47.8% and 23.1%, respectively.
  
  
  CONCLUSIONS
  SWI can provide valuable information for characterization of HCC and DN based on endogenous iron reduction during hepatocarcinogenesis.
authors.affiliation: Department of Diagnostic Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.|Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China.
authors.forename: Ruo-Kun
authors.initials: RK
authors.lastname: Li
authors.affiliation: Department of Radiology, Keck Medical Center, University of Southern California, Los Angeles, California, United States of America.
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Palmer
authors.affiliation: Department of Diagnostic Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Meng-Su
authors.initials: MS
authors.lastname: Zeng
authors.affiliation: Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China.
authors.forename: Jin-Wei
authors.initials: JW
authors.lastname: Qiang
authors.affiliation: Department of Radiology, Keck Medical Center, University of Southern California, Los Angeles, California, United States of America.
authors.forename: Frank
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Diagnostic Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Sheng-Xiang
authors.initials: SX
authors.lastname: Rao
authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Ling-Li
authors.initials: LL
authors.lastname: Chen
authors.affiliation: Siemens Ltd, China Healthcare Sector MR Business, Shanghai, China.
authors.forename: Yong-Ming
authors.initials: YM
authors.lastname: Dai
mesh_terms: D000328:Adult; D000368:Aged; D063646:Carcinogenesis / Q000378:metabolism / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008099:Liver / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D012806:Siderosis / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery
chemical_list: D003287:Contrast Media; D007501:Iron; D019786:Gadolinium DTPA