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Clinical Impact of Gadoxetic Acid-Enhanced Magnetic Resonance Imaging on Hepatoma Management: A Prospective Study

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Abstract

Background

For patients with hepatocellular carcinoma (HCC), gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) improved the diagnosis, migrated Barcelona Clinic Liver Cancer (BCLC) stage, and changed therapeutic decision in retrospective analysis.

Aim

This prospective study was to evaluate the clinical impact of EOB-MRI on HCC management.

Methods

From September 2012 to February 2014, consecutive patients with suspicion of HCC in BCLC early stage by multidetector computed tomography or dynamic MRI with non-specific gadolinium, well liver function reserve, and admitted for resection evaluation were enrolled prospectively. Additional EOB-MRI was performed. The HCC diagnosis, BCLC staging, and treatment decision were obtained in a liver cancer conference. EOB-MRI impact on HCC management was analyzed.

Results

One hundred and three patients including 68 with typical and 35 with atypical HCC nodules in dynamic imaging studies were enrolled. EOB-MRI characterized 3 (4.4 %) benign and 33 (94.3 %) HCC for patients with typical and atypical HCC nodules, respectively. For 90 HCC patients, additional EOB-MRI changed BCLC stage in 25 (27.8 %) and treatment decision in 17 (18.9 %) patients. There were 66 patients with 78 resected nodules including 65 HCCs, 4 intrahepatic cholangiocarcinomas, and 9 benign nodules. Dynamic study and EOB-MRI detected and characterized 69 and 77 nodules, respectively. The sensitivity and accuracy in HCC diagnosis were 98.5 and 85.7 % for EOB-MRI, which were better than those of dynamic study (p < 0.001).

Conclusions

Additional EOB-MRI improved HCC diagnosis in sensitivity, accuracy but not specificity. It changed BCLC staging and treatment decision in 27.8 and 18.9 % of early-stage HCC patients.

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Acknowledgments

The study was supported by Grants (CMRPG891531-2 and CMRPG8B0462-3) from Chang Gung Memorial Hospital to Jing-Houng Wang and Tai-Yi Chen.

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    Authors and Affiliations

    1. Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123, Ta Pei Road, Niao Sung, Kaohsiung, 833, Taiwan, ROC

      Jing-Houng Wang, Chao-Hung Hung, Chien-Hung Chen, Chung-Huang Kuo, Tsung-Hui Hu & Sheng-Nan Lu

    2. Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC

      Tai-Yi Chen, Hsin-You Ou & Yu-Fan Cheng

    3. Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC

      Chih-Chi Wang & Yueh-Wei Liu

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    1. Jing-Houng Wang
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    Correspondence to Sheng-Nan Lu.

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    Jing-Houng Wang and Tai-Yi Chen have contributed equally to this work.

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    Wang, JH., Chen, TY., Ou, HY. et al. Clinical Impact of Gadoxetic Acid-Enhanced Magnetic Resonance Imaging on Hepatoma Management: A Prospective Study. Dig Dis Sci 61, 1197–1205 (2016). https://doi.org/10.1007/s10620-015-3989-x

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