title: Improved Detection of Recurrent Hepatocellular Carcinomas in Arterial Phase With CAIPIRINHA-Dixon-TWIST-Volumetric Interpolated Breath-Hold Examination.
abstract: The aim of this study was to assess the detection rate of recurrent hepatocellular carcinoma (HCC) in arterial phase using multiarterial CAIPIRINHA-Dixon-TWIST-VIBE (MA-CDT-VIBE).
  
  
  
  Fifty-eight patients with possible recurrence of HCC were retrospectively included in this cohort. Patients were scanned with a prototype dynamic contrast-enhanced breath-hold CDT-VIBE sequence, which included 6 arterial subphases with a temporal resolution of 2.64 seconds on a 3 T scanner. Absence and presence of recurrence was documented by consensus of 2 experienced radiologists using magnetic resonance imaging multiphase imaging and follow-up evaluation. The third of 6 arterial subphases was considered the equivalent-to-conventional single arterial phase from the contrast bolus timing perspective. The detection rate of recurrent HCCs in arterial phase by another 2 independent experienced readers was compared for all 6 arterial subphases of MA-CDT-VIBE and the equivalent-to-conventional single arterial phase. Interreader agreement was also calculated.
  
  
  
  Of the 55 patients reviewed, 46 patients (201 lesions) had recurrent HCC and 9 patients had no recurrence. There was an excellent interreader agreement for both MA-CDT-VIBE (κ = 1.000, P < 0.0001) and the equivalent-to-conventional single arterial phase (κ = 0.850, P < 0.0001). MA-CDT-VIBE showed the detection rate of 100% for all lesions with the diameter of less than 1 cm, 1 to 2 cm, and more than 2 cm. The equivalent-to-conventional single arterial phase resulted in the detection rate of 81.1% and 83.1% for all recurrent HCCs by the 2 readers, respectively, with 78.7% and 83.6% for lesions measuring less than 1 cm, 79.2% and 81.2% for lesions measuring 1 to 2 cm, and 89.7% and 87.2% for lesions measuring more than 2 cm.
  
  
  
  Compared with the equivalent-to-conventional single arterial phase, MA-CDT-VIBE with 6 arterial subphases demonstrated higher detection rate of recurrent HCCs in arterial phase and provided a wider arterial observation window, especially for recurrent HCCs less than 2 cm in diameter.
authors.affiliation: From the *Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan; †MR Collaboration, Siemens Healthcare, Shanghai, China; ‡Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD; and §MR Predevelopment, Siemens Healthcare, Erlangen, Germany.
authors.forename: Jinrong
authors.initials: J
authors.lastname: Qu
authors.forename: Shuai
authors.initials: S
authors.lastname: Han
authors.forename: Hongkai
authors.initials: H
authors.lastname: Zhang
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.forename: Zhaoqi
authors.initials: Z
authors.lastname: Wang
authors.forename: Ihab R
authors.initials: IR
authors.lastname: Kamel
authors.forename: Kiefer
authors.initials: K
authors.lastname: Berthold
authors.forename: Nickel Marcel
authors.initials: NM
authors.lastname: Dominik
authors.forename: Shouning
authors.initials: S
authors.lastname: Zhang
authors.forename: Yafeng
authors.initials: Y
authors.lastname: Dong
authors.forename: Lina
authors.initials: L
authors.lastname: Jiang
authors.forename: Cuicui
authors.initials: C
authors.lastname: Liu
authors.forename: Hailiang
authors.initials: H
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D062485:Breath Holding; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media