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

Autor:	Tillman, BG, Gorman, JD, Hru, JM, Lee, MH, King, MC, Sirlin, CB, Marks, RM
Rok vydání:	2018
Předmět:	Gadolinium DTPA Male Carcinoma Liver Neoplasms Clinical Sciences Contrast Media Hepatocellular Middle Aged Magnetic Resonance Imaging Sensitivity and Specificity Nuclear Medicine & Medical Imaging Cross-Sectional Studies Humans Female Retrospective Studies
Zdroj:	Clinical radiology, vol 73, iss 5 Tillman, BG; Gorman, JD; Hru, JM; Lee, MH; King, MC; Sirlin, CB; et al.(2018). Diagnostic per-lesion performance of a simulated gadoxetate disodium-enhanced abbreviated MRI protocol for hepatocellular carcinoma screening. CLINICAL RADIOLOGY, 73(5), 485-493. doi: 10.1016/j.crad.2017.11.013. UC San Diego: Retrieved from: http://www.escholarship.org/uc/item/49z3z3t2
Popis:	AimTo 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 methodsSeventy-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.ResultsInter-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%).ConclusionsThe 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.
Databáze:	OpenAIRE
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