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

SummaryBackgroundTo 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.Material/Methods73 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.ResultsA 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 phase vs. 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 phase vs. 0.910 for DCEMRI (p<0.01) and 0.828 for DCECT (p<0.001).ConclusionsThe 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.

State of the art in abdominal MRI structured reporting: a review

“…It can be diagnosed noninvasively using In this case the number in parenthesis indicates compartments explored and not lesions. In the column "subjective analysis", the number of surveyed referring physicians is reported in parenthesis when available contrast-enhanced MRI and the Liver Imaging-Reporting and Data System (LI-RADS) guidelines have been reported to be highly reliable [12][13][14]. Indeed, they offer recommendations regarding acquisition technique, key imaging findings and provide both a standardized lexicon and a structured reporting template for HCC diagnosis in high-risk patients [15].…”

Optimization of hepatobiliary phase delay time of Gd-EOB-DTPA-enhanced magnetic resonance imaging for identification of hepatocellular carcinoma in patients with cirrhosis of different degrees of severity

“…It has been used more and more frequently in magnetic resonance imaging (MRI) to provide better diagnosis, differential diagnosis, assessment of hepatic function, and imaging of bile ducts in patients with liver-occupying lesions[ 1 - 3 ]. Gd-EOB-DTPA-enhanced MRI (GED-MRI) is proven to have marked advantages over contrast-enhanced computed tomography (CT) in finding smaller hepatocellular carcinoma (HCC), especially those with a diameter less than 20 mm, as well as the recurrent HCC after various antitumor treatments[ 4 , 5 ]. However, a disadvantage of GED-MRI is that it needs remarkably long time for scanning, in which the hepatobiliary phase delay time (HBP-DT) is usually set at 15 to 20 min or longer[ 6 , 7 ].…”

Application of Image Fusion in Diagnosis and Treatment of Liver Cancer

“…The liver-specific contrast agent Gd-EOB-DTPA-enhanced MRI scan has the advantage of clearly displaying tumor lesion boundaries and intrahepatic microscopic lesions. However, due to the length of time required for MRI, images of intrahepatic vessels are likely to contain artifacts due to respiratory non-coordination [175]. With an extensive clinical application of medical image fusion technology, researchers have circumvented the disadvantages of the above techniques via the preoperative fusion of enhanced CT/MRI imaging in ICC.…”