The Diagnostic Performance of Dynamic Contrast-enhanced MR Imaging for Detection of Small Hepatocellular Carcinoma Measuring Up to 2 cm: A Meta-Analysis

Abstract

Results of this meta-analysis suggest that dynamic contrast-enhanced MR imaging has moderate sensitivity and excellent specificity in the detection of HCC up to 2 cm. Gadoxetate disodium contrast agent showed the strongest association with increased sensitivity.

Health economic evaluation of Gd-EOB-DTPA MRI vs ECCM-MRI and multi-detector computed tomography in patients with suspected hepatocellular carcinoma in Thailand and South Korea

“…In addition, recent clinical studies have supported the estimated higher effectiveness of Gd-EOB-DTPA-MRI with even higher differences than estimated by the expert panel in this study 20 . A recent metaanalysis on small HCC <2 cm found that studies in which gadoxetate disodium was used had significantly higher sensitivities than those that used an extracellular agent (92% vs 67%, p 0.001) 21 . However, specificity did not differ significantly between sub-groups (p !…”

Diagnosis of Hepatocellular Carcinoma with Gadoxetic Acid-Enhanced MRI: 2016 Consensus Recommendations of the Korean Society of Abdominal Radiology

“…In comparison with other imaging modalities, gadoxetic acid-enhanced MRI provides a greater opportunity for detection of small or early HCCs (13), which is supported by evidence that gadoxetic acid-enhanced MRI outperforms CT and ECCM-MRI in diagnosis of lesions of sizes < 1–2 cm (66676869). Moreover, a significant proportion of sub-centimeter-sized lesions detected by gadoxetic acid-enhanced MRI are likely to be or turn into HCC within a short time period (7071).…”

“…However, since sequential use of a single imaging modality exhibits similar specificity as simultaneous imaging, with substantially reduced resource expenditure, this policy was discarded in the latest version of the AASLD guidelines (8384). Furthermore, the findings of recent meta-analyses revealed gadoxetic acid-enhanced MRI as exhibiting excellent diagnostic performance for lesions < 2 cm in size (sensitivity, 79–95%; specificity, 89–92%) (6985). Thus, in the era of gadoxetic acid-enhanced MRI, the necessity of the 2-cm cut-off appears to be diminishing.…”

Chinese consensus on the clinical application of hepatobiliary magnetic resonance imaging contrast agent: Gadoxetic acid disodium

“…International guidelines including the American Association for the Study of Liver Diseases, the European Association for the Study of the Liver, and the rules for diagnosis and treatment of primary liver cancer in China (2011 version), recommend dynamic contrast‐enhanced MSCT or MRI for diagnosing HCC. Several studies have shown that the diagnostic accuracy of Gd‐EOB‐DTPA‐enhanced MRI for small HCC (≤2.0 cm) is better than that of multiphase dynamic enhanced MSCT, plain MRI, or a dynamic conventional contrast‐enhanced MRI scan . Moreover, the HBP, Gd‐EOB‐DTPA‐enhanced MRI can improve the ability to detect and characterize HCC.…”