title: Diagnostic Accuracy of Gd-EOB-DTPA for Detection Hepatocellular Carcinoma (HCC): A Comparative Study with Dynamic Contrast Enhanced Magnetic Resonance Imaging (MRI) and Dynamic Contrast Enhanced Computed Tomography (CT).
abstract: BACKGROUND
  To compare the diagnostic accuracy of hepato-biliary (HB) phase with gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA) with dynamic contrast-enhanced MR imaging (DCEMRI) and contrast-enhanced CT (DCECT) for hepatocellular carcinoma (HCC) detection.
  
  
  METHODS
  73 patients underwent DCECT and Gd-EOB-DTPA-3T-MR. Lesions were classified using a five-point confidence scale. Reference standard was a combination of pathological evidence and tumor growth at follow-up CT/MR at 12 months. Receiver Operating Characteristic (ROC) curves were obtained.
  
  
  RESULTS
  A total of 125 lesions were confirmed in 73 patients. As many as 74 were HCCs and 51 were benign. Area under the curve (AUC) was 0.984 for DCEMRI+HB phasevs.0.934 for DCEMRI (p<0.68) and 0.852 for DCECT (p<0.001). For lesions >20 mm (n.40), AUC was 0.984 for DCEMRI+HB phase, 0.999 for DCEMRI, and 0.913 for DCECT, (p=n.s.). For lesions <20 mm (n.85) AUC was 0.982 for DCEMRI+HB phasevs.0.910 for DCEMRI (p<0.01) and 0.828 for DCECT (p<0.001).
  
  
  CONCLUSIONS
  The addition of HB phase to DCEMRI provides an incremental accuracy of 4.5% compared to DCEMRI and DCECT for HCC detection. The accuracy of Gd-EOB-DTPA-3T-MR significantly improves for lesions <20 mm. No significant improvement is observed for lesions >20 mm and patients with Child-Pugh class B or C.
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Napoli, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Imbriaco
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Napoli, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: De Luca
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Napoli, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Coppola
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Napoli, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Fusari
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Napoli, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Klain
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Napoli, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Puglia
authors.affiliation: Institute of Biostructure and Bioimaging, National Research Council (CNR), Napoli, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Mainenti
authors.affiliation: Institute of Biostructure and Bioimaging, National Research Council (CNR), Napoli, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Liuzzi
authors.affiliation: Department of Advanced Biomedical Sciences, University "Federico II", Napoli, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Maurea
keywords: Contrast Media; Liver Neoplasms; Magnetic Resonance Imaging; Tomography Scanners, X-Ray Computed