MRI in differentiating malignant versus benign portal vein thrombosis in patients with hepatocellular carcinoma: Value of post contrast imaging with subtraction

Autor: Hamed Jalaeian, Deniz Cebi Olgun, Eric Niendorf, Benjamin Spilseth, Luke A. Krystosek, Rakhee Gawande, Nathan Rubin
Přispěvatelé: İÜC, Cerrahpaşa Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü
Rok vydání: 2019
Předmět:
Adult
Male
Gastrointestinal
medicine.medical_specialty
Cirrhosis
Carcinoma
Hepatocellular
Hepatocellular carcinoma
behavioral disciplines and activities
Article
030218 nuclear medicine & medical imaging
Diagnosis
Differential
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Thrombus
Aged
Retrospective Studies
Venous Thrombosis
business.industry
Portal Vein
Liver Neoplasms
Area under the curve
Subtraction
General Medicine
Arteries
MR
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Portal vein thrombosis
Venous thrombosis
Diffusion Magnetic Resonance Imaging
Liver
030220 oncology & carcinogenesis
Area Under Curve
Female
Radiology
business
human activities
psychological phenomena and processes
Portal vein thrombus
Diffusion MRI
Zdroj: Eur J Radiol
ISSN: 1872-7727
Popis: Spilseth, Benjamin/0000-0002-8330-3394; Rubin, Nathan/0000-0001-7162-5225 WOS:000481609300014 PubMed ID: 31439264 Purpose: To evaluate MR imaging parameters including quantitative multiphasic post-contrast enhancement with subtraction and qualitative diffusion weighted imaging (DWI) in differentiating benign versus malignant portal venous thrombosis (PVT) in patients with hepatocellular carcinoma (HCC). Method: Radiology reports over a 6-year period ending February 2016 were searched for key words indicating presence of both HCC and PVT on abdominal MRI. 39 patients were identified with PVT characterized as benign or malignant based on pathologic data or serial imaging growth criteria. Image review was performed by two subspecialized radiologists blinded to the diagnosis and medical chart. Signal intensity for regions of interest were recorded within the portal vein thrombus as well as the portal vein on pre-contrast and dynamic post-contrast phases without and with subtraction. Qualitative parameters for DWI and presence of PV expansion were also evaluated. Results: Percent enhancement generated high area under the curve (AUC) for both readers on all non-subtraction phases: arterial (0.95/0.98), portal venous (0.97/0.97) and delayed phase (0.96/0.99) and subtraction phases: arterial (0.91/0.96), portal venous (0.94/0.99) and delayed phases (0.96/0.97). Statistically significant differences were observed between benign and malignant PVT for both readers for PV expansion (p = < 0.001/0.006). No qualitative DWI parameter reached statistical significance for both readers. Conclusions: Post-contrast and subtraction MRI can reliably distinguish malignant from benign PVT in patients with HCC using subtracted or non-subtracted images and at arterial, portal venous, or delayed phase timing. NIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [P30CA077598]; National Center for Advancing Translational Sciences of the National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Center for Advancing Translational Sciences (NCATS) [UL1-TR002494]; NATIONAL CANCER INSTITUTEUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Cancer Institute (NCI) [P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598, P30CA077598] Funding Source: NIH RePORTER; NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCESUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Center for Advancing Translational Sciences (NCATS) [UL1TR002494, UL1TR002494, UL1TR002494, UL1TR002494, UL1TR002494] Funding Source: NIH RePORTER Research reported in this publication was supported by NIH grant P30CA077598 utilizing the Biostatistics and Bioinformatics Core shared resource of the Masonic Cancer Center, University of Minnesota and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1-TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Databáze: OpenAIRE
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