MR imaging features for improved diagnosis of hepatocellular carcinoma in the non-cirrhotic liver: Multi-center evaluation

Autor: Stefan Breitenstein, E Schade, Roger Hunziker, Georgios C. Sotiropoulos, Philippe Bachellier, P. A. Clavien, Michael A. Patak, Andrea Frilling, Hatem Alkadhi, Michael A. Fischer, Olivio F. Donati, Adam Bartlett, Dimitri A. Raptis, John L. McCall
Přispěvatelé: University of Zurich, Fischer, M A
Rok vydání: 2015
Předmět:
Adult
Gadolinium DTPA
Male
Pathology
medicine.medical_specialty
Carcinoma
Hepatocellular
Cirrhosis
medicine.medical_treatment
Medizin
Contrast Media
610 Medicine & health
Sensitivity and Specificity
Adenoma
Liver Cell
Diagnosis
Differential
Lesion
medicine
2741 Radiology
Nuclear Medicine and Imaging
Hepatectomy
Humans
Radiology
Nuclear Medicine and imaging
10217 Clinic for Visceral and Transplantation Surgery
Aged
Retrospective Studies
medicine.diagnostic_test
10042 Clinic for Diagnostic and Interventional Radiology
business.industry
Liver Neoplasms
Focal nodular hyperplasia
Magnetic resonance imaging
General Medicine
Hepatitis C
Middle Aged
Image Enhancement
medicine.disease
Magnetic Resonance Imaging
Liver
Focal Nodular Hyperplasia
Hepatocellular carcinoma
Female
medicine.symptom
Differential diagnosis
business
Follow-Up Studies
Zdroj: European Journal of Radiology. 84:1879-1887
ISSN: 0720-048X
Popis: To determine MR-imaging features for the differentiation between hepatocellular carcinoma (HCC) and benign hepatocellular tumors in the non-cirrhotic liver.107 consecutive patients without liver cirrhosis (46 male; 45 ± 14 years) who underwent liver resection due to suspicion of HCC were included in this multi-center study. The following imaging features were assessed: lesion diameter and demarcation, satellite-lesions, central-scar, capsule, fat-content, hemorrhage, vein-infiltration and signal-intensity (SI) on native T1-, T2- and dynamic-enhanced T1-weighted images (center versus periphery). In addition, contrast-media (CM) uptake in the liver specific phase was analyzed in a sub-group of 42 patients.Significant differences between HCC (n=55) and benign lesions (n=52) were shown for native T1-, T2- and dynamic-enhanced T1-SI, fat-content, and satellite-lesions (all, P.05). Independent predictors for HCC were T1-hypointensity (odds-ratio, 4.81), T2-hypo-/hyperintensity (5.07), lack of central tumor-enhancement (3.36), and satellite-lesions (5.78; all P0.05). Sensitivity and specificity of HCC was 91% and 75% respectively for two out-of four independent predictors, whereas specificity reached 98% for all four predictors. Sub-analysis, showed significant differences in liver specific CM uptake between HCC (n=18) and benign lesions (n=24; P0.001) and revealed lack of liver specific CM uptake (odds-ratio, 2.7) as additional independent feature for diagnosis of HCC.Independent MRI features indicating HCC are T1-hypointensity, T2-hypo- or hyperintensity, lack of central tumor-enhancement, presence of satellite-lesions and lack of liver specific CM-uptake. These features may have the potential to improve the diagnosis of HCC in the non-cirrhotic liver.
Databáze: OpenAIRE
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