Pitfalls in liver MRI: Technical approach to avoiding misdiagnosis and improving image quality

et al. 2020

BMC Med Imaging

Background: To evaluate the utility of non-invasive parameters derived from T1 mapping and diffusion-weighted imaging (DWI) on gadoxetic acid-enhanced MRI for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods: A total of 94 patients with single HCC undergoing partial hepatectomy was analyzed in this retrospective study. Preoperative T1 mapping and DWI on gadoxetic acid-enhanced MRI was performed. The parameters including precontrast, postcontrast and reduction rate of T1 relaxation time and apparent diffusion coefficient (ADC) values were measured for differentiating MVI-positive HCCs (n = 38) from MVI-negative HCCs (n = 56). The receiver operating characteristic curve (ROC) was analyzed to compare the diagnostic performance of the calculated parameters. Results: MVI-positive HCCs demonstrated a significantly lower reduction rate of T1 relaxation time than that of MVInegative HCCs (39.4% vs 49.9, P < 0.001). The areas under receiver operating characteristic curve (AUC) were 0.587, 0.728, 0.824, 0,690 and 0.862 for the precontrast, postcontrast, reduction rate of T1 relaxation time, ADC and the combination of reduction rate and ADC, respectively. The cutoff value of the reduction rate and ADC calculated through maximal Youden index in ROC analyses was 44.9% and 1553.5 s/mm 2. To achieve a better diagnostic performance, the criteria of combining the reduction rate lower than 44.9% and the ADC value lower than 1553.5 s/mm 2 was proposed with a high specificity of 91.8% and accuracy of 80.9%. Conclusions: The proposed criteria of combining the reduction rate of T1 relaxation time lower than 44.9% and the ADC value lower than 1553.5 s/mm 2 on gadoxetic acid-enhanced MRI holds promise for evaluating MVI status of HCC.

Section: Discussionsupporting

confidence: 78%

Value of T1 mapping on gadoxetic acid-enhanced MRI for microvascular invasion of hepatocellular carcinoma: a retrospective study

et al. 2020

BMC Med Imaging

“…In line with our study, lower ADC value has been proven helpful for predicting MVI of HCC because it reflects higher tissue cellularity and decreased micro-capillary perfusion [9]. There are several pitfalls of DWI that affect the reliability of the ADC measurement including [21,22]: (1) limited image quality with poor signal-to-noise ratio and low spatial resolution; (2) more sensitive to motion and air susceptibility, especially for pulsation artifacts in left robe; (3) misregistration artifacts on ADC map;…”

Section: Discussionsupporting

confidence: 78%

Value of T1 Mapping on Gadoxetic acid-enhanced MRI for Microvascular Invasion of Hepatocellular Carcinoma: A Retrospective Study

et al. 2020

Preprint

Background: To evaluate the utility of non-invasive parameters driving from T1 mapping on gadoxetic acid-enhanced MRI for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC) compared with diffusion-weighted imaging (DWI).Methods: A total of 94 patients with single HCC undergoing partial hepatectomy was included in the retrospective study, who underwent preoperative gadoxetic acid-enhanced MRI combined with DWI and T1 mapping. Parameters including precontrast, postcontrast and reduction rate of T1 relaxation time and ADC values were measured for differentiating MVI-positive HCCs (n=38) from MVI-negative HCCs (n=56). The receiver operating characteristic curve (ROC) was analyzed to compare the diagnostic performance of the calculated parameters.Results: The mean value of postcontrast T1 relaxation time were significantly higher in MVI-positive HCCs that MVI-negative HCCs (621.0 vs. 536.5, P <0.001). MVI-positive HCCs demonstrated significantly lower reduction rates of T1 relaxation time and lower ADC values than MVI-negative HCCs (39.4% vs 49.9, P<0.001; 1.495×10-3mm2/s vs 1.620×10-3mm2/s, P=0.003, respectively). The area under receiver operating characteristic curves were 0.587, 0.728, 0.824 and 0.690 for precontrast, postcontrast, reduction rate of T1 relaxation time and ADC, respectively. The reduction rate of T1 relaxation time was the most reliable feature with sensitivity, specificity and accuracy of the cut-off value (44.9%) of 79.0%, 73.2%, 75.5%, respectively.Conclusions: Reduction rate of T1 relaxation time on gadoxetic acid-enhanced MRI holds promise for evaluating MVI status of HCC.

Section: Discussionsupporting

confidence: 78%

Value of T1 Mapping on Gadoxetic acid-enhanced MRI for Microvascular Invasion of Hepatocellular Carcinoma: A Retrospective Study

et al. 2020

Preprint

Background: To evaluate the utility of non-invasive parameters driving from T1 mapping and diffusion-weighted imaging (DWI) on gadoxetic acid-enhanced MRI for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC). Methods: A total of 94 patients with single HCC undergoing partial hepatectomy was analyzed in the retrospective study. Preoperative T1 mapping and DWI on gadoxetic acid-enhanced MRI was performed. The parameters including precontrast, postcontrast and reduction rate of T1 relaxation time and apparent diffusion coefficient (ADC) values were measured for differentiating MVI-positive HCCs (n=38) from MVI-negative HCCs (n=56). The receiver operating characteristic curve (ROC) was analyzed to compare the diagnostic performance of the calculated parameters. Results: MVI-positive HCCs demonstrated a significantly lower reduction rate of T1 relaxation time than that of MVI-negative HCCs (39.4% vs 49.9, P<0.001). The areas under receiver operating characteristic curve (AUC) were 0.587, 0.728, 0.824 and 0,690 for precontrast, postcontrast, reduction rate of T1 relaxation time and ADC, respectively. The cut-off value of the reduction rate and ADC calculated though maximal Youden index in ROC analyses was 44.9% and 1553.5 s/mm2. To achieve a better diagnostic performance, the criteria that combining the reduction rate lower than 44.9% and the ADC value lower than 1553.5 s/mm2 was proposed with a high specificity of 91.8% and accuracy of 80.9%. Conclusions: The criteria that combining the reduction rate of T1 relaxation time lower than 44.9% and the ADC value lower than 1553.5 s/mm2 on gadoxetic acid-enhanced MRI holds promise for evaluating MVI status of HCC.