Hepatocellular carcinoma in a North American population: Does hepatobiliary MR imaging with Gd‐EOB‐DTPA improve sensitivity and confidence for diagnosis?

Bashir, Mustafa R.; Gupta, Rajan T.; Davenport, Matthew S.; Allen, Brian C.; Jaffe, Tracy A.; Ho, Lisa M.; Boll, Daniel T.; Merkle, Elmar M.

doi:10.1002/jmri.23818

Cited by 93 publications

(55 citation statements)

References 48 publications

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“…20,22 Previous studies showed improved diagnostic sensitivity/ PPV by adding HP images to dynamic MR imaging or by comparing them with CECT. 7,8,20,[23][24][25] Our results agreed with those of the previous studies. Using hypointensity as a major feature, we can more effectively categorize a hypovascular HCC of at least grade LR3.…”

Section: Discussionsupporting

confidence: 93%

Added Value of a Gadoxetic Acid-enhanced Hepatocyte-phase Image to the LI-RADS System for Diagnosing Hepatocellular Carcinoma

et al. 2016

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Purpose: We investigated the added value of the hypointensity on hepatocyte-phase (HP) imaging of gadoxetic acid-enhanced MRI (EOB-MRI) in the 2014 version of the Liver Imaging Reporting and Data System (LI-RADS) for distinguishing hepatocellular carcinoma (HCC) from benign hepatic lesions in patients with chronic liver disease.Methods: We retrospectively evaluated targeted lesions (111 HCCs, 28 benign hepatic lesions) of 139 patients (101 men, 38 women; aged 18 to 89 years, mean age, 68 « 11 years) with chronic liver disease. EOB-MRI and dynamic contrast-enhanced computed tomography (CECT) were performed within 3 months. Two abdominal radiologists independently reviewed 3 imaging datasets: (1) EOB-MRI without an HP image using the LI-RADS system (MR imaging without HP); (2) EOB-MRI with an HP image using a modified version of the LI-RADS system in which hypointensity on the HP image was used as an additional major criterion of malignancy (MR imaging with HP); and (3) dynamic contrast-enhanced computed tomography (CECT) images using the LI-RADS system. We evaluated intra-and inter-reader agreement with kappa statistics along with 95% confidence intervals and compared diagnostic sensitivity and specificity of the 3 imaging datasets with McNemar's test.Results Conclusion: The use of an HP image from EOB-MRI as an additional major criterion improved the sensitivity of LI-RADS to distinguish HCCs from benign hepatic lesions while retaining high specificity.

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Section: Discussionsupporting

confidence: 93%

Added Value of a Gadoxetic Acid-enhanced Hepatocyte-phase Image to the LI-RADS System for Diagnosing Hepatocellular Carcinoma

et al. 2016

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“…It has actually become common to encounter cases where hypervascular HCC or nodule-in-nodule HCC that is undetectable by MDCT is detected in a routine screening by EOB-MRI because of early enhancement in the arterial phase or clear hypointensity in the hepatobiliary phase [11,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103]. Furthermore, studies comparing the diagnostic performance of EOB-MRI and MDCT for hypervascular HCC have shown that EOB-MRI is superior or, at the very l...…”

Section: Diagnostic Algorithmmentioning

confidence: 99%

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

et al. 2014

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Surveillance and diagnostic algorithms for hepatocellular carcinoma (HCC) have already been described in guidelines published by the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver and the European Organisation for Research and Treatment of Cancer (EASL-EORTC), and the Japan Society of Hepatology (JSH), but the content of these algorithms differs slightly. The JSH algorithm mainly differs from the other two algorithms in that it is highly sophisticated and considers the functional imaging techniques of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI (EOB-MRI) and Sonazoid contrast-enhanced ultrasound (CEUS) to be very important diagnostic modalities. In contrast, the AASLD and EASL-EORTC algorithms are less advanced and suggest that a diagnosis be made based solely on hemodynamic findings using dynamic CT/MRI and biopsy findings. A consensus meeting regarding the JSH surveillance and diagnostic algorithm was held at the 50th Liver Cancer Study Group of Japan Congress, and a 2014 update of the algorithm was completed. The new algorithm reaffirms the very important role of EOB-MRI and Sonazoid CEUS in the surveillance and diagnosis of liver cancer and is more sophisticated than those currently used in the United States and Europe. This is now an optimized algorithm that can be used to diagnose early-stage to classical HCC easily and highly accurately.

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“…Until now, accumulating evidence has demonstrated that gadoxetic acid-enhanced MRI may provide better detection and characterization of HCCs compared with MDCT by permitting simultaneous evaluation of tumor vascularity as well as hepatocellular function [29,65,78,81,82,105,106,107,108,109,110]. Since OATP expression declines during hepatocarcinogenesis, approximately 88-95% of HCCs have low or no OATP8 expression and do not take up gadoxetic acid and therefore show hypointensity on hepatobiliary phase imaging [111,112].…”

Section: Diagnostic Criteriamentioning

confidence: 99%

2014 KLCSG-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma: HCC Diagnostic Algorithm

Lee

Park

Choi

2014

Dig Dis

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Hepatocellular carcinoma (HCC) is the fifth most commonly occurring cancer in Korea and typically has a poor prognosis with a 5-year survival rate of only 28.6%. Therefore, it is of paramount importance to achieve the earliest possible diagnosis of HCC and to recommend the most up-to-date optimal treatment strategy in order to increase the survival rate of patients who develop this disease. After the establishment of the Korean Liver Cancer Study Group (KLCSG) and the National Cancer Center (NCC), Korea jointly produced for the first time the Clinical Practice Guidelines for HCC in 2003, revised them in 2009, and published the newest revision of the guidelines in 2014, including changes in the diagnostic criteria of HCC and incorporating the most recent medical advances over the past 5 years. In this review, we will address the noninvasive diagnostic criteria and diagnostic algorithm of HCC included in the newly established KLCSG-NCC guidelines in 2014, and review the differences in the criteria for a diagnosis of HCC between the KLCSG-NCC guidelines and the most recent imaging guidelines endorsed by the European Organisation for Research and Treatment of Cancer (EORTC), the Liver Imaging Reporting and Data System (LI-RADS), the Organ Procurement and Transplantation Network (OPTN) system, the Asian Pacific Association for the Study of the Liver (APASL) and the Japan Society of Hepatology (JSH).

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Hepatocellular carcinoma in a North American population: Does hepatobiliary MR imaging with Gd‐EOB‐DTPA improve sensitivity and confidence for diagnosis?

Abstract: Hepatobiliary phase imaging may improve small lesion detection (<1 cm) and characterization of lesions in general, in MRI of the cirrhotic liver with Gd-EOB-DTPA.

Cited by 93 publications

References 48 publications

Added Value of a Gadoxetic Acid-enhanced Hepatocyte-phase Image to the LI-RADS System for Diagnosing Hepatocellular Carcinoma

Added Value of a Gadoxetic Acid-enhanced Hepatocyte-phase Image to the LI-RADS System for Diagnosing Hepatocellular Carcinoma

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

2014 KLCSG-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma: HCC Diagnostic Algorithm

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