Differentiating hepatocellular carcinoma from dysplastic nodules at gadobenate dimeglumine-enhanced hepatobiliary-phase magnetic resonance imaging

Gatto, Anna Maria; Gaetano, Anna Maria De; Giuga, M; Ciresa, M.; Siciliani, L.; Miele, Luca; Riccardi, Laura; Pizzolante, Fabrizio; Gl, Rapaccini; Gasbarrini, Antonio; Giuliante, Felice; Vecchio, Fabio Maria; Pompili, Maurizio; Bonomo, Lorenzo

doi:10.1007/s00261-012-9950-y

Cited by 21 publications

(10 citation statements)

References 27 publications

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“…Besides, the distinction between HGDNs and welldifferentiated HCCs is often problematic and sometimes impossible, even histologically [18,31] (particularly when FNB/ CNB rather than surgery is performed), and these two entities are to be recognized as a continuum rather than individual discrete states [24]. These observations support the value of the differential diagnosis between the group obtained by unifying HCCs and HGDNs and the group of LGDNs, which has already been used in the literature [32,33]. When analyzing [34,35] investigating the utility of DWI and DPI together in the diagnosis of FLLs in the cirrhotic liver, none of which analyzed the value of the lesion-to-liver ADC ratio and the distinction between HGDNs and LGDNs.…”

Section: Discussionsupporting

confidence: 55%

Role of diffusion-weighted imaging, apparent diffusion coefficient and correlation with hepatobiliary phase findings in the differentiation of hepatocellular carcinoma from dysplastic nodules in cirrhotic liver

et al. 2014

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Section: Discussionsupporting

confidence: 55%

Role of diffusion-weighted imaging, apparent diffusion coefficient and correlation with hepatobiliary phase findings in the differentiation of hepatocellular carcinoma from dysplastic nodules in cirrhotic liver

et al. 2014

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“…In humans, 95% of the dose of Gd-BOPTA are excreted in urine and only approximately 3%-5% of the dose are excreted into bile[8,22]. Although Gd-BOPTA through the liver metabolism is little, its hepatic elimination is slow and it can maintain the liver enhancement for 40 to 120 min[23]. Previous research findings have indicated that the degree of enhancement of GD-EOB-DTPA decreased as the stage of hepatic fibrosis progressed[24].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of gadobenate dimeglumine-enhanced hepatocyte-phase magnetic resonance imaging in evaluating hepatic fibrosis and hepatitis

Li¹,

Chen²,

Xiao³

et al. 2017

WJG

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AIMTo evaluate the diagnostic value of gadobenate dimeglumine (Gd-BOPTA)-enhanced hepatocyte-phase magnetic resonance imaging (MRI) in evaluating hepatic fibrosis and hepatitis.METHODSHepatocyte-phase images of Gd-BOPTA-enhanced MRI were retrospectively evaluated in 76 patients with chronic liver disease. These patients were classified into five groups according to either the histopathological fibrosis stage (S0-S4) or the histopathological hepatitis grade (G0-G4). The relative enhancement ratio (RE) of the liver parenchyma in the T1-vibe sequence was calculated by measuring the signal intensity before (SI pre) and 90 min after (SI post) intravenous injection of Gd-BOPTA using the following formula: RE = (SI post - SI pre)/SI pre. One-way analysis of variance was used to compare the difference between the relative RE in the hepatocyte phase (REh) and the stage of hepatic fibrosis and the grade of hepatitis. Pearson’s product-moment correlation analysis was used to evaluate the relationship between the REh and the levels of serologic liver functional parameters.RESULTSAccording to histopathological hepatic fibrosis stage, the 76 patients were classified into five groups: 16 in S0, 15 in S1, 21 in S2, 9 in S3, and 15 in S4 group. According to histopathological hepatitis grade, the 76 patients were also classified into five groups: 0 in G0, 44 in G1, 22 in G2, 8 in G3, and 2 in G3 group. With regard to the stage of hepatic fibrosis, REh showed significant differences between the S2 and S3 groups and between the S2 and S4 groups (P < 0.05), but no significant difference was observed between the other groups. With regard to the grade of hepatitis, REh showed significant differences between the G1 and G2 groups and between the G1 and G4 groups (P < 0.05), but no significant difference was observed between the other groups. Increased REh showed correlations with decreased serum levels of TB, ALT and AST (P < 0.05).CONCLUSIONTo some extent, measuring the REh using Gd-BOPTA-enhanced MRI might be a noninvasive technique for assessing the stage of hepatic fibrosis. This method is able to differentiate no/mild hepatitis from advanced hepatitis. TB, ALT and AST levels can predict the degree of liver enhancement in the hepatocyte phase of Gd-BOPTA-enhanced MRI.

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“…In 14 out of 71 cases (19 %), HCC appears as isointense lesions with wash-out signs. This imaging pattern suggests that tumour neo-angiogenesis starts after the disruption of peri-portal space [19, 20]. The main feature of dysplastic nodules was hypovascular lesion (iso/hypointense) with a loss of signal intensity during the late dynamic phase.…”

Section: Discussionmentioning

confidence: 99%

Qualitative analysis of small (≤2 cm) regenerative nodules, dysplastic nodules and well-differentiated HCCs with gadoxetic acid MRI

et al. 2016

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BackgroundThe 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.MethodsSeventy-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.ResultsGood 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).ConclusionsGadoxetic-acid MRI is a reliable tool for the characterization of HCC and lesions at high risk to further develop.

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Differentiating hepatocellular carcinoma from dysplastic nodules at gadobenate dimeglumine-enhanced hepatobiliary-phase magnetic resonance imaging

Abstract: DPI is helpful in differentiating HCCs and HGDNs from LGDNs. Demonstration of hypointensity on DPI should raise the suspicion of HGDN or hypovascular HCC in the case of nodules with atypical dynamic pattern.

Cited by 21 publications

References 27 publications

Role of diffusion-weighted imaging, apparent diffusion coefficient and correlation with hepatobiliary phase findings in the differentiation of hepatocellular carcinoma from dysplastic nodules in cirrhotic liver

Role of diffusion-weighted imaging, apparent diffusion coefficient and correlation with hepatobiliary phase findings in the differentiation of hepatocellular carcinoma from dysplastic nodules in cirrhotic liver

Diagnostic value of gadobenate dimeglumine-enhanced hepatocyte-phase magnetic resonance imaging in evaluating hepatic fibrosis and hepatitis

Qualitative analysis of small (≤2 cm) regenerative nodules, dysplastic nodules and well-differentiated HCCs with gadoxetic acid MRI

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