title: Comparison of Contrast-Enhanced Ultrasound and Gadolinium-Ethoxybenzyl-Diethylenetriamine Pentaacetic Acid-Enhanced MRI for the Diagnosis of Macroscopic Type of Hepatocellular Carcinoma.
abstract: OBJECTIVE
  We compared the efficacy of contrast-enhanced ultrasound sonography (CEUS) with sonazoid and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI for the assessment of macroscopic classification of nodular hepatocellular carcinoma (HCC).
  
  
  METHODS
  Seventy-seven consecutive patients with 79 surgically resected HCCs who underwent both preoperative CEUS and Gd-EOB-DTPA-enhanced MRI were enrolled in this retrospective study. Based on the macroscopic diagnosis of resected specimens, nodules were categorized into the simple nodular (SN) and non-SN type HCC. Two hepatologists independently assessed image datasets of the post-vascular phase of CEUS and hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI to compare their diagnostic performance.
  
  
  RESULTS
  Gd-EOB-DTPA-enhanced MRI enabled the evaluation of macroscopic classification in a significantly larger number of nodules than CEUS (78/79 (98.7%) vs. 70/79 (88.6%), p < 0.05). Of 70 nodules that could be evaluated by both modalities, 41 and 29 nodules were pathologically categorized as SN and non-SN, respectively. The areas under the receiver operating characteristic curve (AUC) for non-SN did not differ between CEUS and Gd-EOB-DTPA-enhanced MRI (reader 1: 0.748 for CEUS, 0.808 for MRI; reader 2: 0.759 for CEUS, 0.787 for MRI). The AUC of combined CEUS and Gd-EOB-DTPA-enhanced MRI for SN HCC was 0.855 (reader 1) and 0.824 (reader 2), indicating higher AUC values for the combined modalities.
  
  
  CONCLUSIONS
  The diagnostic performance for macroscopic classification of nodular HCC of CEUS was comparable with that of Gd-EOB-DTPA-enhanced MRI, although some HCCs could not be evaluated by CEUS owing to lower detectability. The combination of the 2 modalities had a more accurate diagnostic performance.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Iwamoto
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Imai
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Kogita
authors.forename: Takumi
authors.initials: T
authors.lastname: Igura
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Sawai
authors.forename: Kazuto
authors.initials: K
authors.lastname: Fukuda
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakahara
authors.forename: Osakuni
authors.initials: O
authors.lastname: Morimoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Seki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohashi
authors.forename: Norihiko
authors.initials: N
authors.lastname: Fujita
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D005290:Ferric Compounds; D019786:Gadolinium DTPA; D006801:Humans; D007501:Iron; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010087:Oxides; D011300:Preoperative Care; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; D010087:Oxides; C069727:Sonazoid; C073590:gadolinium ethoxybenzyl DTPA; D007501:Iron; D019786:Gadolinium DTPA