title: Impact of hepatobiliary phase liver MRI versus Contrast-Enhanced Ultrasound after an inconclusive extracellular gadolinium-based contrast-enhanced MRI for the diagnosis of benign hepatocellular tumors.
abstract: To compare the added values of hepatobiliary phase (HBP) MRI and contrast-enhanced ultrasound (CEUS) in addition to inconclusive extracellular gadolinium-based contrast-enhanced MRI (CE-MRI) to characterize benign hepatocellular tumors (BHT).
  
  
  
  Eighty-three BHT-46 focal nodular hyperplasia (FNH) and 37 hepatocellular adenomas (HCA)-with inconclusive CE-MRI in 54 patients (43 women and 11 men, mean age 42 years old ± 14.8) were retrospectively analyzed. All patients underwent both HBP-MRI and CEUS. Two radiologists independently reviewed 2 sets of images, SET-1: CE-MRI and HBP-MRI; SET-2: CE-MRI and CEUS, and classified lesions as "definite FNH," "possible FNH," or "definitely not FNH." Sensitivity (Se) and specificity (Spe) were compared between the two sets; subgroup analyses according to the lesion's size were performed.
  
  
  
  Regardless of lesion size, the respective Se and Spe of both datasets were not statistically different (95.7 and 100% vs. 76.1 and 94.6% for set-1 and -2 respectively; p = 0.18). For lesions larger than 35 mm, although both sets had similar specificity (100%), sensitivity was higher for SET-1 (100% vs. 40%); p = 0.04. Tumor classifications using SET-1 and SET-2 could have changed patient management in 35/54 (64.8%) and 33/54 (61.1%) of all patients, respectively.
  
  
  
  HBP-MRI or CEUS should be performed after an inconclusive CE-MRI. Both can change patient management by avoiding unnecessary biopsy or surveillance. The use of HBP-MRI should be advocated over CEUS in larger (>35 mm) lesions.
authors.affiliation: Imagerie Medicale, CHU Henri Mondor, AP-HP, Groupe Henri Mondor Albert Chenevier, 51 avenue du Marechal de Lattre de Tassigny, 94010, Créteil, France.
authors.forename: Lambros
authors.initials: L
authors.lastname: Tselikas
authors.affiliation: Imagerie Medicale, CHU Henri Mondor, AP-HP, Groupe Henri Mondor Albert Chenevier, 51 avenue du Marechal de Lattre de Tassigny, 94010, Créteil, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Pigneur
authors.affiliation: Imagerie Medicale, CHU Henri Mondor, AP-HP, Groupe Henri Mondor Albert Chenevier, 51 avenue du Marechal de Lattre de Tassigny, 94010, Créteil, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Roux
authors.affiliation: Imagerie Medicale, CHU Henri Mondor, AP-HP, Groupe Henri Mondor Albert Chenevier, 51 avenue du Marechal de Lattre de Tassigny, 94010, Créteil, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Baranes
authors.affiliation: Hepatology Department, AP-HP, Groupe Henri Mondor Albert Chenevier, Créteil, 94010, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Costentin
authors.affiliation: Imagerie Medicale, CHU Henri Mondor, AP-HP, Groupe Henri Mondor Albert Chenevier, 51 avenue du Marechal de Lattre de Tassigny, 94010, Créteil, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Roche
authors.affiliation: Department of Pathology, AP-HP, Groupe Henri Mondor Albert Chenevier, Créteil, 94010, France.|Universite Paris Est Creteil, Créteil, 94010, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Calderaro
authors.affiliation: Imagerie Medicale, CHU Henri Mondor, AP-HP, Groupe Henri Mondor Albert Chenevier, 51 avenue du Marechal de Lattre de Tassigny, 94010, Créteil, France.
authors.forename: Edouard
authors.initials: E
authors.lastname: Herin
authors.affiliation: Universite Paris Est Creteil, Créteil, 94010, France.|Liver Surgery Department, AP-HP, Groupe Henri Mondor Albert Chenevier, Créteil, 94010, France.|INSERM IMRB Unit U 955, Equipe 18, Créteil, 94010, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Laurent
authors.affiliation: Department of Pathology, AP-HP, Groupe Henri Mondor Albert Chenevier, Créteil, 94010, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Zafrani
authors.affiliation: Universite Paris Est Creteil, Créteil, 94010, France.|Liver Surgery Department, AP-HP, Groupe Henri Mondor Albert Chenevier, Créteil, 94010, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Azoulay
authors.affiliation: Hepatology Department, AP-HP, Groupe Henri Mondor Albert Chenevier, Créteil, 94010, France.|Universite Paris Est Creteil, Créteil, 94010, France.
authors.forename: Ariane
authors.initials: A
authors.lastname: Mallat
authors.affiliation: Imagerie Medicale, CHU Henri Mondor, AP-HP, Groupe Henri Mondor Albert Chenevier, 51 avenue du Marechal de Lattre de Tassigny, 94010, Créteil, France.|Universite Paris Est Creteil, Créteil, 94010, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Rahmouni
authors.affiliation: Imagerie Medicale, CHU Henri Mondor, AP-HP, Groupe Henri Mondor Albert Chenevier, 51 avenue du Marechal de Lattre de Tassigny, 94010, Créteil, France. alain.luciani@aphp.fr.|Universite Paris Est Creteil, Créteil, 94010, France. alain.luciani@aphp.fr.|INSERM IMRB Unit U 955, Equipe 18, Créteil, 94010, France. alain.luciani@aphp.fr.
authors.forename: Alain
authors.initials: A
authors.lastname: Luciani
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D003287:Contrast Media; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine
keywords: CEUS; Focal nodular hyperplasia; Hepatobiliary phase MRI; Hepatocellular Adenoma; Hepatospecific contrast agents