Differentiation of well-differentiated hepatocellular carcinomas from other hepatocellular nodules in cirrhotic liver: Value of SPIO-enhanced MR imaging at 3.0 Tesla
✍ Scribed by Hee Sun Park; Jeong-Min Lee; Se Hyung Kim; Samuel Chang; Soo Jin Kim; Joon Koo Han; Byung Ihn Choi
- Book ID
- 102905052
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 563 KB
- Volume
- 29
- Category
- Article
- ISSN
- 1053-1807
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✦ Synopsis
Abstract
Purpose
To determine the diagnostic value of superparamagnetic iron oxide (SPIO)‐enhanced MRI for the differentiation of well‐differentiated hepatocellular carcinomas (WD‐HCCs) from other hepatocellular nodules in cirrhotic liver.
Materials and Methods
This study included 114 patients with 216 histologically confirmed hepatocellular nodules, i.e., 23 dysplastic nodules (DNs), 37 WD‐HCCs, and 156 moderately or poorly differentiated HCCs (MD‐/PD HCCs), who underwent SPIO‐enhanced MRI at 3.0T. MRI included T2‐weighted fast‐spin echo and T2*‐weighted gradient recalled echo (GRE) sequences before and after administration of ferucarbotran. The contrast‐to‐noise ratio (CNR) of the lesion was calculated. Reviewers analyzed signal intensity (SI) of the nodules and their enhancement features on SPIO‐enhanced images. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the diagnosis of WD‐HCC were also calculated.
Results
The mean CNR of WD‐HCC was significantly higher than that of DN on T2*‐weighted image. Incomplete high SI on SPIO‐enhanced T2*‐weighted images were seen in 56.8% of WD‐HCC. The most prevalent enhancement features of WD‐HCCs on SPIO‐enhanced T2*‐weighted images, were iso SI with high SI foci [32.5% (12/37)] and homogenous subtle high SI [24.3% (9/37)]. Alternatively, 22 of 23 DNs (95.7%) showed low‐ or iso SI, and 145 of 156 (94.9%) MD‐/PD HCCs showed strong high SI. When iso SI with high SI foci or subtle homogenous high SI nodule was considered as diagnostic criteria for WD‐HCC, we could identify 56.8% of the WD‐HCCs but only 4.4% of the DNs and 3.2% of the MD‐/PD HCCs.
Conclusion
WD‐HCCs have characteristic enhancement features that differentiate them from DNs and MD‐/PD HCCs on SPIO‐enhanced 3.0T MRI. The lesion conspicuity was better on T2*‐weighted images than that on T2‐weighted images. J. Magn. Reson. Imaging 2009;29:328–335. © 2009 Wiley‐Liss, Inc.