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Zhang Qing, Huang Yuan, Xiong Hao, Peng Jie Department of Radiology, Jingzhou No 1 People’s Hospital and First Affiliated Hospital of Yangtze University, Jingzhou City, Hubei Province, 434000, People’s Republic of ChinaCorrespondence: Peng Jie, Department of Radiology, The Jingzhou No 1 People’s Hospital and First Affiliated Hospital of Yangtze University, Hangkong Road, Shashi District, Jingzhou City, Hubei Province, 434000, People’s Republic of China, Tel +86 181 6313 1595, Email 18163131595vip@sina.comObjective: To explore the potential value of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) magnetic resonance imaging (MRI) in the diagnosis of hepatocellular carcinoma (HCC) in LR-3/4 lesions by adding computed tomography (CT) delayed images based on the Liver Imaging Reporting And Data System (LI-RADS).Methods: The differences in clinical and imaging characteristics between hepatocellular carcinoma and non-HCC were compared, and logistic regression was used to analyze the imaging risk factors for the diagnosis of HCC. Based on the main and HCC-specific auxiliary features of Gd-EOB-DTPA MRI, the HCC diagnostic model 1 was established, and the diagnostic efficacy was analyzed. Based on model 1, delayed phase CT images were added to establish model 2 to find reliable predictors of HCC diagnosis. Receiver operating characteristic (ROC) analysis and the DeLong test were used to compare the two models.Results: There was a significant difference in serum AFP between HCC and non-HCC (P = 0.008). Based on main and HCC-specific auxiliary features of Gd-EOB-DTPA MRI, enhancing capsule (OR = 0.197, 95% CI = 0.06– 0.595, P = 0.005) and washout (OR = 10.345, 95% CI = 3.460– 30.930, P < 0.001) were independent risk factors in Model 1. After adding CT delayed-phase images to build model 2, enhancing capsule (OR = 0.132, 95% CI = 0.139– 0.449, P = 0.001), MRI and (or) CT washout (OR = 0.052, 95% CI = 0.016– 0.172, P < 0.001) were reliable predictors for HCC diagnosis. The AUC of model 1 was 0.808, sensitivity was 63.46%, and specificity was 85.00%. The AUC of model 2 was 0.854, the sensitivity was 71.20%, and the specificity was 85.00%. DeLong test (P = 0.040) demonstrated the diagnostic efficacy of model 2 significantly superior than model 1.Conclusion: Tumor washout and enhanced capsule are reliable factors for the diagnosis of HCC. Gd-EOB-DTPA MRI with delayed phase CT images can improve the sensitivity and diagnostic efficiency of HCC in LR-3/4 lesions on the premise of maintaining high specificity. Future studies are required to reinforce our finding.Keywords: liver imaging reporting and data system, gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid, computed tomography, hepatocellular carcinoma, diagnostic performance |
