Diagnostic per-lesion performance of a simulated gadoxetate disodium-enhanced abbreviated MRI protocol for hepatocellular carcinoma screening.

Autor: Tillman BG; Department of Radiology, Naval Medical Center San Diego, San Diego, CA, USA., Gorman JD; Department of Radiology, Naval Medical Center San Diego, San Diego, CA, USA., Hru JM; Department of Radiology, Naval Medical Center San Diego, San Diego, CA, USA., Lee MH; Department of Radiology, Naval Medical Center San Diego, San Diego, CA, USA., King MC; Department of Radiology, Naval Medical Center San Diego, San Diego, CA, USA., Sirlin CB; Liver Imaging Group, Department of Radiology, University of California, San Diego, San Diego, CA, USA., Marks RM; Department of Radiology, Naval Medical Center San Diego, San Diego, CA, USA; Uniformed Services University of the Health Sciences, Department of Radiology and Radiological Sciences, Bethesda, MD, USA. Electronic address: robert.m.marks.mil@mail.mil.
Jazyk: angličtina
Zdroj: Clinical radiology [Clin Radiol] 2018 May; Vol. 73 (5), pp. 485-493. Date of Electronic Publication: 2017 Dec 12.
DOI: 10.1016/j.crad.2017.11.013
Abstrakt: Aim: To evaluate the diagnostic per-lesion performance of a simulated gadoxetate disodium-enhanced abbreviated MRI (AMRI) in cirrhotic and chronic hepatitis B (CHB) patients for hepatocellular carcinoma (HCC) screening.
Materials and Methods: Seventy-nine consecutive patients at risk for HCC due to cirrhosis and/or CHB were included in this retrospective study. For each patient, the first gadoxetate disodium-enhanced MRI between 2008 through 2014 was analysed. Two independent readers read an anonymised abbreviated image set comprising axial T1-weighted (W) images with fat saturation in the hepatobiliary phase, 20 minutes or more after gadoxetate injection, and axial T2W single-shot fast spin echo images. Each observation >10 mm was scored as negative or suspicious for HCC. Inter-reader agreement was assessed. A composite reference standard was used to determine the per-lesion diagnostic performance for each reader.
Results: Inter-reader agreement was substantial (κ = 0.75). The final reference standard showed 27 HCCs in 13 patients (median 21 mm, range 11-100 mm). The two readers each correctly scored 23 as suspicious for HCC (sensitivity = 85.2%), scored a total of 27 and 32 observations as suspicious for HCC (positive predictive value [PPV] = 85.2% and 71.9%), and scored 83 and 78 observations or complete examinations as negative for HCC (negative predictive value [NPV] = 95.2% and 94.9%).
Conclusions: The AMRI protocol provides higher per-lesion sensitivity and NPV than reported values for ultrasound, the current recommended technique for screening, and similar per-lesion sensitivity and PPV to reported values for complete dynamic contrast-enhanced MRI.
(Published by Elsevier Ltd.)
Databáze: MEDLINE
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