Assessment of arterial hypervascularity of hepatocellular carcinoma: comparison of contrast-enhanced US and gadoxetate disodium-enhanced MR imaging
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To compare contrast-enhanced (CE) ultrasound with gadoxetate disodium-enhanced magnetic resonance (MR) imaging in the assessment of arterial hypervascularity of hepatocellular carcinoma (HCC) and dysplastic nodule (DN), with CT during hepatic arteriography (CTHA) as the reference standard.
This study included 54 consecutively diagnosed patients, with 57 histologically confirmed HCCs and 3 DNs (high-grade). All patients underwent CE ultrasound, gadoxetate disodium-enhanced MR imaging and CTHA. Two trained diagnostic radiologists interpreted the CTHA images and rated the degree of intratumoral arterial vascularity by consensus using a five-point confidence scale as the reference standard. In the observer study, the degrees of vascularity on CE ultrasound and gadoxetate disodium-enhanced MR images were qualitatively analysed by four independent readers using a five-point confidence scale. Diagnostic accuracy was analysed by receiver-operating characteristic (ROC) analysis.
The diagnostic accuracies of the average area under the ROC curve (AUC) were significantly greater with CE ultrasound (average AUC: 0.94; 95% confidence interval [CI]: 0.88–1.00) than with gadoxetate disodium-enhanced MR imaging (average AUC 0.84, 95% CI 0.74–0.93, P = 0.0014).
Contrast-enhanced ultrasound yields a significantly higher AUC value than gadoxetate disodium-enhanced MR imaging in the assessment of arterial hypervascularity of HCC and DN.
• Arterial hypervascularity is an important feature determining treatment options in hepatocellular carcinoma.
• It can be assessed by contrast-enhanced (CE) ultrasound or magnetic resonance (MR) imaging.
• CE ultrasound was more accurate than Gd-EOB-DTPA MRI in assessing intratumoral vascularity.
• Hypovascular hepatic nodules should be further investigated using CE ultrasound.
KeywordsUltrasound Contrast media MR imaging Gadoxetic acid Hepatocellular carcinoma
- 13.Ichikawa T, Saito K, Yoshioka N et al (2010) Detection and characterization of focal liver lesions: a Japanese phase III, multicenter comparison between gadoxetic acid disodium-enhanced magnetic resonance imaging and contrast-enhanced computed tomography predominantly in patients with hepatocellular carcinoma and chronic liver disease. Invest Radiol 45:133–141PubMedCrossRefGoogle Scholar
- 21.International Working Party (1995) Terminology of nodular hepatocellular lesion. Hepatology 22:983–993Google Scholar
- 23.Sakamoto M, Hirohashi S (1998) Natural history and prognosis of adenomatous hyperplasia and early hepatocellular carcinoma: multi-institutional analysis of 53 nodules followed up for more than 6 months and 142 patients with single early hepatocellular carcinoma treated by surgical resection or percutaneous ethanol injection. Jpn J Clin Oncol 28:604–608PubMedCrossRefGoogle Scholar
- 25.Matsui O, Kadoya M, Kameyama T et al (1989) Adenomatous hyperplastic nodules in the cirrhotic liver: differentiation from hepatocellular carcinoma with MR imaging. Radiology 173:1223–126Google Scholar