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Comparison of gadoxetic acid-enhanced magnetic resonance imaging and contrast-enhanced computed tomography with histopathological examinations for the identification of hepatocellular carcinoma: a multicenter phase III study

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has an important role in preoperative evaluation of hepatocellular carcinoma (HCC). However, no studies have prospectively performed intraindividual comparison of gadoxetic acid-enhanced 3T MRI and multidetector-row computed tomography (MDCT) with histopathological examination for the detection of HCCs. We prospectively compared the efficacies of gadoxetic acid-enhanced MRI and multiphasic contrast-enhanced MDCT with that of histopathological examination, used as a reference standard, for the detection of HCC in surgical candidates.

Methods

The study was approved by the institutional review boards at each of four centers. Patients scheduled to undergo multiphasic CT, gadoxetic acid-enhanced MRI, and liver surgery were prospectively included in this study. The diagnostic abilities of MRI and CT were evaluated and compared on the basis of sensitivity and positive predictive value for detection of and differentiation between HCCs and benign lesions.

Results

Fifty-four patients with 83 histopathologically confirmed HCCs were included in the study. Combined interpretation of the dynamic and hepatobiliary phases of gadoxetic acid-enhanced MRI showed statistically higher sensitivity for lesion detection (83 %) than did interpretation of multiphasic MDCT images (70 %; p < 0.001). The mean area under each alternative free-response receiver operating characteristics curve was significantly higher for MR images (0.927) than for CT images (0.864, p < 0.01).

Conclusions

The sensitivity for preoperative detection of HCCs was higher for gadoxetic acid-enhanced MRI than for multiphasic MDCT imaging.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Faculty of Medicine-Radiology, Kinki University, Osakasayama, Osaka, Japan

    Masakatsu Tsurusaki, Masahiro Okada & Takamichi Murakami

  2. National Cancer Center Hospital-Diagnostic Radiology, 5-1-1, Tsukiji, Chuo-ku, Tokyo, Tokyo, 104-0045, Japan

    Keitaro Sofue

  3. Kobe University Graduate School of Medicine-Radiology, 7-5-2, Kusunoki-Cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan

    Keitaro Sofue & Kazuhiro Kitajima

  4. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan

    Hiroyoshi Isoda

  5. Department of Raiology, Dokkyo Medical School, Mibu, Tochigi, Japan

    Kazuhiro Kitajima

Authors
  1. Masakatsu Tsurusaki
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  2. Keitaro Sofue
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  3. Hiroyoshi Isoda
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  4. Masahiro Okada
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  5. Kazuhiro Kitajima
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  6. Takamichi Murakami
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Correspondence to Masakatsu Tsurusaki.

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Tsurusaki, M., Sofue, K., Isoda, H. et al. Comparison of gadoxetic acid-enhanced magnetic resonance imaging and contrast-enhanced computed tomography with histopathological examinations for the identification of hepatocellular carcinoma: a multicenter phase III study. J Gastroenterol 51, 71–79 (2016). https://doi.org/10.1007/s00535-015-1097-5

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  • DOI: https://doi.org/10.1007/s00535-015-1097-5

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