Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Catholic Cancer Research Institute, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
Eur Radiol. 2020 Aug;30(8):4150-4163. doi: 10.1007/s00330-020-06754-4. Epub 2020 Mar 12.
This study was conducted in order to compare the diagnostic performance of noncontrast and abbreviated MRI using gadoxetic acid for detecting hepatocellular carcinoma (HCC) in initially diagnosed HCC patients.
We identified 140 consecutive patients with newly diagnosed HCC (173 HCCs) within the Milan criteria, who underwent liver MRI using gadoxetic acid between 2015 and 2016. One hundred twenty-three consecutive patients without HCC who underwent liver MRI in the same period for HCC surveillance were enrolled for the control group. Two radiologists independently reviewed two MRI sets: a noncontrast set and an abbreviated set. The noncontrast set consists of T2 FSE/ssFSE, T1 in- and out-of-phase image, DWI, and the ADC map. The abbreviated set consists of T2 FSE/ssFSE, hepatobiliary phase image 20 min after gadoxetic acid injection, DWI, and the ADC map.
In a per-patient analysis, sensitivity of reviewer 1 for noncontrast and abbreviated sets was 85.7 and 90.0%, respectively. The specificity for both noncontrast and abbreviated sets was 92.7%. For reviewer 2, sensitivity of noncontrast and abbreviated sets was 86.4 and 89.3%, respectively. Per-patient specificity of reviewer 2 was 92.7% for both noncontrast and abbreviated sets. The sensitivity and specificity of two image sets were not significantly different for both reviewers. The per-tumor sensitivity of noncontrast and abbreviated sets was 81.5 and 84.4% for reviewer 1, respectively, and 79.8 and 84.4% for reviewer 2, respectively. There was no significant difference.
Noncontrast and abbreviated MRI using gadoxetic acid showed comparable diagnostic performance for detecting patients with HCCs in the early stage.
• Diagnostic performance of noncontrast MRI and abbreviated MRI using gadoxetic acid for detecting HCCs is comparable in patients with HCCs in the early stage. • Noncontrast MRI and abbreviated MRI showed high sensitivity and specificity for detecting HCCs in the early stage. • Outcomes of surveillance for HCC in high-risk patients can be improved by adopting these simplified and focused MRI protocols.
本研究旨在比较钆塞酸增强磁共振成像（MRI）平扫及简化扫描在初诊符合米兰标准的肝细胞癌（HCC）患者中的诊断效能。
我们纳入了 2015 年至 2016 年间行钆塞酸增强 MRI 检查的 140 例符合米兰标准的初诊 HCC 患者（173 个 HCC）。同期因 HCC 筛查行 MRI 检查且无 HCC 的 123 例连续患者纳入对照组。两位放射科医生独立阅片，分别评估平扫及简化扫描两套 MRI 影像。平扫包括 T2 FSE/ssFSE、T1 同相位及反相位、DWI 和 ADC 图。简化扫描包括 T2 FSE/ssFSE、注射钆塞酸后 20 分钟的肝胆期图像、DWI 和 ADC 图。
在每位患者的分析中，医生 1 对平扫及简化扫描的敏感度分别为 85.7%和 90.0%，特异度均为 92.7%。医生 2 对平扫及简化扫描的敏感度分别为 86.4%和 89.3%，特异度均为 92.7%。两种扫描方法的敏感度和特异度在两位医生间均无显著差异。医生 1 对平扫及简化扫描的每个肿瘤的敏感度分别为 81.5%和 84.4%，医生 2 分别为 79.8%和 84.4%，差异均无统计学意义。
平扫及简化扫描钆塞酸增强 MRI 对早期 HCC 患者的诊断效能相当。
• 早期 HCC 患者中，平扫 MRI 和钆塞酸增强简化 MRI 的诊断性能相当。• 平扫及简化扫描对早期 HCC 均具有较高的敏感度和特异度。• 采用这些简化和重点突出的 MRI 方案可改善高危患者 HCC 的监测结果。
