Qualitative analysis of small (≤2 cm) regenerative nodules, dysplastic nodules and well-differentiated HCCs with gadoxetic acid MRI.
The characterization of small lesions in cirrhotic patients is extremely difficult due to the overlap of imaging features among different entities in the step-way of the hepatocarcinogenesis. The aim of our study was to evaluate the role of gadoxetic-acid MRI in the differentiation of small (≤2 cm) well-differentiated hepatocellular carcinomas from regenerative and dysplastic nodules.



Seventy-three cirrhotic patients, with 118 focal liver lesions (≤2 cm) were prospectively recruited. MRI examination was performed with a 3T magnet and the study protocol included T1 - and T2-weighted pre-contrast sequences and T1 -weighted gadoxetic-acid enhanced post-contrast sequences obtained during the arterial, venous, late dynamic and hepatobiliary phases. All lesions were pathologically confirmed. Two radiologists blinded to clinical and pathological information evaluated two imaging datasets; another radiologist analysed the signal intensity characteristics of each lesion. Sensitivity, specificity and diagnostic accuracy were considered for statistical analysis.



Good agreement was reported between the two readers (κ 0.70). Both readers reported a significantly improved sensitivity (57.7 and 66.2 vs 74.6 and 83.1) and diagnostic accuracy (0.717 and 0.778 vs 0.843 and 0.901) with the adjunction of the hepatobiliary phase 57.7 vs 74.6 and 66.2 vs 83.1 (p ≤ 0.04).



Gadoxetic-acid MRI is a reliable tool for the characterization of HCC and lesions at high risk to further develop.
Sapienza, University of Rome, Rome, Italy. micdimartino@hotmail.it.
Michele
0000-0003-1504-1166
M
Di Martino
Sapienza, University of Rome, Rome, Italy.
Michele
M
Anzidei
Sapienza, University of Rome, Rome, Italy.
Fulvio
F
Zaccagna
Sapienza, University of Rome, Rome, Italy.
Luca
L
Saba
Sapienza, University of Rome, Rome, Italy.
Sandro
S
Bosco
Sapienza, University of Rome, Rome, Italy.
Massimo
M
Rossi
Sapienza, University of Rome, Rome, Italy.
Stefano
S
Ginanni Corradini
Sapienza, University of Rome, Rome, Italy.
Carlo
C
Catalano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA / Q000378:metabolism*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D047368:Tumor Burden; D055815:Young Adult
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
Dysplastic nodule; Liver specific contrast agent; Magnetic resonance; Regenerative nodule; Well-differentiated HCC