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European Radiology

, Volume 25, Issue 9, pp 2789–2796 | Cite as

Subcentimeter hypervascular nodule with typical imaging findings of hepatocellular carcinoma in patients with history of hepatocellular carcinoma: natural course on serial gadoxetic acid-enhanced MRI and diffusion-weighted imaging

  • Kyoung Doo Song
  • Seong Hyun KimEmail author
  • Hyo Keun Lim
  • Sin-Ho Jung
  • Insuk Sohn
  • Hyung Sik Kim
Hepatobiliary-Pancreas

Abstract

Objectives

To evaluate the natural course of subcentimeter hypervascular nodules at high risk for developing into hepatocellular carcinomas (SHNHR) using serial magnetic resonance imaging (MRI) in patients with a history of hepatocellular carcinoma (HCC).

Methods

An SHNHR was defined as a subcentimeter hypervascular nodule having typical imaging findings of HCC on gadoxetic acid-enhanced MRI and diffusion-weighted imaging. We included 39 patients with 46 SHNHRs (mean size ± standard deviation, 6.1 ± 1.6 mm; range, 3.2 – 9.0 mm). Overt HCC was defined as pathology proven HCC or a nodule larger than 1 cm with typical imaging findings of HCC. The cumulative rate and the independent predictive factors for progression to overt HCC were evaluated.

Results

The median follow-up period was 139 days (range, 64 – 392 days). The cumulative progression rate to overt HCC at 3, 6, 9, and 12 months was 13.9 %, 61.7 %, 83.2 %, and 89.9 %. The initial size of SHNHR was a significant predictor of progression to overt HCC, with an optimal cut-off value of 5.5 mm.

Conclusion

The progression rate of SHNHR to overt HCC within 12 months was high (89.9 %) in patients with history of HCC. The initial size of SHNHR was an important predictor for progression to overt HCC.

Key Points

Most SHNHRs (89.9 %) progressed to overt HCCs within 12 months.

Initial size was an important predictor for progression to overt HCCs.

The optimal cut-off value for initial nodule size was 5.5 mm.

Keywords

Subcentimeter Hypervascular nodule Hepatocellular carcinoma Natural course Progression rate 

Abbreviations

MRI

Magnetic resonance imaging

HCC

Hepatocellular carcinoma, DWI, Diffusion-weighted imaging

T2WI

T2-weighted image

SI

Signal intensity

SHNHR

Subcentimeter hypervascular nodule at high risk for developing into hepatocellular carcinoma

AASLD

American Association for the Study of Liver Disease

RFA

Radiofrequency ablation

TACE

Transcatheter arterial chemoembolization

AFP

α-fetoprotein

TVDT

Tumour volume doubling time

BCLC

Barcelona Clinic Liver Cancer

Notes

Acknowledgments

The scientific guarantor of this publication is Young Soo Do, the head of radiology department. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. Two of the authors have significant statistical expertise. Sin-Ho Jung and Insuk Sohn.

Institutional review board approval was obtained. Written informed consent was waived by the Institutional review board. No study subjects or cohorts have been previously reported. Methodology: retrospective, observational, performed at one institution.

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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Kyoung Doo Song
    • 1
  • Seong Hyun Kim
    • 1
    Email author
  • Hyo Keun Lim
    • 1
  • Sin-Ho Jung
    • 2
    • 3
  • Insuk Sohn
    • 2
  • Hyung Sik Kim
    • 4
  1. 1.Department of Radiology and Center for Imaging Science, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  2. 2.Center for Biostatistics and Clinical Epidemiology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  3. 3.Samsung Advanced Institute for Health Sciences and TechnologySungkyunkwan University School of MedicineSeoulRepublic of Korea
  4. 4.Department of Radiology, Gil Medical CenterGachon Medical SchoolIncheonRepublic of Korea

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