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Hepatocellular carcinoma: Detection with diffusion-weighted versus contrast-enhanced magnetic resonance imaging in pretransplant patients

Park, Mi-Suk ; Kim, Sooah ; Patel, Jignesh ; Hajdu, Cristina H. ; G. Do, Richard K. ; Mannelli, Lorenzo ; Babb, James S. ; Taouli, Bachir

Hepatology (Baltimore, Md.), 2012-07, Vol.56 (1), p.140-148 [Periódico revisado por pares]

Hoboken: Wiley Subscription Services, Inc., A Wiley Company

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Título:
Hepatocellular carcinoma: Detection with diffusion-weighted versus contrast-enhanced magnetic resonance imaging in pretransplant patients
Autor: Park, Mi-Suk ; Kim, Sooah ; Patel, Jignesh ; Hajdu, Cristina H. ; G. Do, Richard K. ; Mannelli, Lorenzo ; Babb, James S. ; Taouli, Bachir
Assuntos: Adult ; Aged ; Biological and medical sciences ; Biopsy, Needle ; Carcinoma, Hepatocellular - diagnosis ; Carcinoma, Hepatocellular - surgery ; Cohort Studies ; Contrast Media ; Diffusion ; Diffusion Magnetic Resonance Imaging - methods ; Female ; Gadolinium DTPA ; Gastroenterology. Liver. Pancreas. Abdomen ; Hepatology ; Humans ; Image Enhancement - methods ; Immunohistochemistry ; Liver - pathology ; Liver cancer ; Liver cirrhosis ; Liver Neoplasms - diagnosis ; Liver Neoplasms - surgery ; Liver Transplantation ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Magnetic Resonance Imaging - methods ; Male ; Medical sciences ; Middle Aged ; NMR ; Nuclear magnetic resonance ; Observer Variation ; Patients ; Preoperative Care - methods ; Retrospective Studies ; Sensitivity and Specificity ; Tumors
É parte de: Hepatology (Baltimore, Md.), 2012-07, Vol.56 (1), p.140-148
Notas: ArticleID:HEP25681
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Potential conflict of interest: Nothing to report.
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Descrição: This study evaluates the performance of diffusion‐weighted magnetic resonance imaging (DWI) for the detection of hepatocellular carcinoma (HCC) in pre–liver transplantation patients, compared and combined with contrast‐enhanced T1‐weighted imaging (CET1WI), using liver explant as the standard of reference. We included 52 patients with cirrhosis (40 men, 12 women; mean age, 56 years) who underwent DWI and CET1WI within 90 days of liver transplantation. Magnetic resonance images were analyzed for HCC detection in three separate sessions by two independent observers: DWI images (DW‐set), CET1WI (CE‐set), and all images together (All‐set). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), per‐patient accuracy, and per‐lesion PPV were calculated for each image set. A total of 72 HCCs were present in 33 patients at explant (mean size, 1.5 cm [range, 0.3‐6.2 cm]). Per‐patient sensitivity and NPV of CE‐set were significantly higher than those of DW‐set when using pooled data between observers (P = 0.02 and 0.03, respectively), whereas specificity, PPV, and accuracy were equivalent. Per‐lesion sensitivity was significantly higher for CE‐set versus DW‐set (59.0% versus 43.8%; P = 0.008, pooled data from two observers). When stratified by lesion size, the difference was significant only for lesions with a size between 1 and 2 cm (42.0% for DW‐set versus 74.0% for CE‐set; P = 0.001). The addition of DWI to CET1WI improved sensitivity for the more experienced observer. Conclusion: DWI is outperformed by CET1WI for detection of HCC, but represents a reasonable alternative to CET1WI for detection of HCC with a size above 2 cm. The addition of DWI to CET1WI slightly increases the detection rate. (HEPATOLOGY 2012;56:140–148)
Editor: Hoboken: Wiley Subscription Services, Inc., A Wiley Company
Idioma: Inglês

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Hepatocellular carcinoma: Detection with diffusion-weighted versus contrast-enhanced magnetic resonance imaging in pretransplant patients

Park, Mi-Suk ; Kim, Sooah ; Patel, Jignesh ; Hajdu, Cristina H. ; G. Do, Richard K. ; Mannelli, Lorenzo ; Babb, James S. ; Taouli, Bachir

Hoboken: Wiley Subscription Services, Inc., A Wiley Company

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