title: Change in Liver Imaging Reporting and Data System Characterization of Focal Liver Lesions Using Gadoxetate Disodium Magnetic Resonance Imaging Compared With Contrast-Enhanced Computed Tomography.
abstract: OBJECTIVE
  The aim of this study was to determine whether gadoxetate-enhanced magnetic resonance imaging (MRI) improves lesion characterization in patients at risk for hepatocellular carcinoma compared with computed tomography (CT).
  
  
  METHODS
  Forty-nine patients with indeterminate lesions found at contrast-enhanced CT were prospectively enrolled and imaged using gadoxetate-enhanced hepatobiliary phase (HBP) MRI within 30 days of their initial CT. Three readers graded each lesion at CT and MRI using the Liver Imaging Reporting and Data System (LI-RADS) v2014 major criteria and HBP characterization as an ancillary feature. Patients were followed for an average of 1.8 years to document growth or stability of each lesion.
  
  
  RESULTS
  The Liver Imaging Reporting and Data System categorization changed for 71% (52/73) of lesions based on HBP MRI compared with CT, with 30% (22/73) of lesions upgraded and 41% (30/73) of lesions downgraded. There was almost perfect agreement between readers for arterial phase hyperintensity and HBP hypointensity, with lower interreader agreement for washout and capsule appearance. On the basis of composite clinical follow-up, lesions that were subsequently classified as hepatocellular carcinoma were assigned a higher LI-RADS category on HBP MRI when compared with CT.
  
  
  CONCLUSIONS
  For patients with indeterminate lesions seen on contrast-enhanced CT, HBP MRI using gadoxetate improves lesion characterization when using LI-RADS v2014 criteria.
authors: From the *Department of Radiology and Biomedical Imaging and †Department of Radiology, Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA; ‡Department of Radiology, MD Anderson Cancer Center, Houston, TX; and §Division of Surgical Oncology, Department of Surgery, University of California, San Francisco; and ∥Division of Gastroenterology and Hepatology, Department of Medicine, San Francisco Veterans Affairs Medical Center, San Francisco, CA.
authors: Thomas A
authors: TA
authors: Hope
authors: Rizwan
authors: R
authors: Aslam
authors: Stefanie
authors: S
authors: Weinstein
authors: Benjamin M
authors: BM
authors: Yeh
authors: Carlos U
authors: CU
authors: Corvera
authors: Alex
authors: A
authors: Monto
authors: Judy
authors: J
authors: Yee
mesh_terms: D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D011873:Radiology Information Systems; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA