Detection of small hepatocellular carcinoma: can gadoxetic acid-enhanced magnetic resonance imaging replace combining gadopentetate dimeglumine-enhanced and superparamagnetic iron oxide-enhanced magnetic resonance imaging?

Investigative Radiology
Y K KimG Park

Abstract

To investigate whether gadoxetic acid-enhanced magnetic resonance imaging (MRI) has the diagnostic capability and sensitivity comparable to the combination of gadopentetate dimeglumine-enhanced MRI and superparamagnetic iron oxide-enhanced MRI (double-contrast MRI) in the detection of small hepatocellular carcinomas (HCCs). Forty-one patients with 56 HCCs (size range, 0.5-2.0 cm) who underwent gadoxetic acid-enhanced MRI and double-contrast MRI with a mean interval of 4 days (range, 3-9 days) were included in this study. HCCs were diagnosed by histology (n = 25) and imaging findings (n = 31). Two observers independently reviewed the gadoxetic acid set (unenhanced, early dynamic, and hepatocyte phase images) and the double-contrast MRI set, at an initial reading session, and then reached consensus. Diagnostic accuracy and sensitivity were evaluated using the alternative-free response receiver operator characteristic method. Diagnostic accuracy (AZ) and sensitivity were similar for both image sets (0.955, 83.9% for gadoxetic acid set; 0.952, 80.4% for double-contrast MRI set) (P > 0.05). There were 5 and 3 HCCs that were verified only on the gadoxetic acid set and double-contrast MRI set, respectively. All 9 HCCs that were not ve...Continue Reading

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