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
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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).
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.
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.
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.
• 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.
KeywordsSubcentimeter Hypervascular nodule Hepatocellular carcinoma Natural course Progression rate
Magnetic resonance imaging
Hepatocellular carcinoma, DWI, Diffusion-weighted imaging
Subcentimeter hypervascular nodule at high risk for developing into hepatocellular carcinoma
American Association for the Study of Liver Disease
Transcatheter arterial chemoembolization
Tumour volume doubling time
Barcelona Clinic Liver Cancer
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.
- 5.Nasu K, Kuroki Y, Tsukamoto T, Nakajima H, Mori K, Minami M (2009) Diffusion-weighted imaging of surgically resected hepatocellular carcinoma: imaging characteristics and relationship among signal intensity, apparent diffusion coefficient, and histopathologic grade. AJR Am J Roentgenol 193:438–444PubMedCrossRefGoogle Scholar