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Evaluation of an abbreviated screening MRI protocol for patients at risk for hepatocellular carcinoma

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Abstract

Purpose

In this study, we compare an abbreviated screening MRI protocol (aMRI), utilizing only dynamic contrast-enhanced images, to a conventional liver MRI (cMRI) for the characterization of observations in at-risk patients.

Materials and methods

164 consecutive HCC screening MRIs were retrospectively analyzed. Two sets of de-identified image sets were created: one with all acquired sequences including T2- and diffusion-weighted sequences (cMRI), and one with only T1-weighted precontrast and dynamic post-contrast images utilizing an extracellular gadolinium contrast agent (aMRI). Three readers assigned a LI-RADS score based on the lesion with the highest LI-RADS category using the aMRI and cMRI datasets during separate reads.

Results

There was no change between the aMRI and cMRI LI-RADS categorization in 93%, 96%, and 96% of cases for readers 1, 2, and 3, respectively. In the majority of the discrepant cases, the score increased from LI-RADS 3 to LI-RADS 4 due to the presence of ancillary features on T2 and DWI. Kappa values for interobserver variability demonstrated fair-to-moderate LI-RADS agreement among the 3 readers.

Conclusion

There was strong agreement between the abbreviated T1-only MRI protocol and a full liver MRI, with only 5% of cases changing LI-RADS categorization due to the inclusion of T2 and DWI. The estimated time to run this abbreviated MRI is approximately 7–10 min, possibly allowing for a more cost-effective screening MRI than our cMRIs.

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Authors and Affiliations

  1. Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA

    Jennifer Y. Lee, Eugene J. Huo, Stefanie Weinstein, Judy Yee & Thomas A. Hope

  2. Department of Gastroenterology, University of California, San Francisco, San Francisco, CA, USA

    Alexander Monto

  3. Department of Surgery, University of California, San Francisco, San Francisco, CA, USA

    Carlos U. Corvera

  4. Department of Radiology, Veterans Affairs Medical Center, San Francisco, CA, USA

    Stefanie Weinstein, Charmaine Santos, Judy Yee & Thomas A. Hope

  5. Department of Medicine, Veterans Affairs Medical Center, San Francisco, CA, USA

    Alexander Monto

Authors
  1. Jennifer Y. Lee
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  2. Eugene J. Huo
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  3. Stefanie Weinstein
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  4. Charmaine Santos
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  5. Alexander Monto
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  6. Carlos U. Corvera
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  7. Judy Yee
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  8. Thomas A. Hope
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Corresponding author

Correspondence to Thomas A. Hope.

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Conflict of interest

Jennifer Y. Lee, Eugene J. Huo, Stefanie Weinstein, Charmaine Santos, Alexander Monto, Carlos U. Corvera, Judy Yee and Thomas A. Hope declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The need for individual informed consent was waived by our institutional review board (IRB) for this retrospective study.

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Lee, J.Y., Huo, E.J., Weinstein, S. et al. Evaluation of an abbreviated screening MRI protocol for patients at risk for hepatocellular carcinoma. Abdom Radiol 43, 1627–1633 (2018). https://doi.org/10.1007/s00261-017-1339-5

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  • DOI: https://doi.org/10.1007/s00261-017-1339-5

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