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How frequently does hepatocellular carcinoma develop in at-risk patients with a negative liver MRI examination with intravenous Gadobenate dimeglumine?

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objective

To determine the rate of development of clinically significant liver nodules (LR-4, LR-5, LR-M) after a negative MRI in an HCC screening population.

Methods

This retrospective study included patients at risk of developing HCC requiring imaging surveillance who had undergone multiphase Gadobenate dimeglumine-enhanced MRI that was negative and had follow up LI-RADS compliant multiphase CTs or MRIs for at least 12 months or positive follow-up within 12 months. Follow-up examinations were classified as negative (no nodules or only LR-1 nodules) or positive (nodule other than LR-1). Time-to-first positive examination, types of nodules, and cumulative incidence of nodule development were recorded.

Results

204 patients (mean age 58.9 ± 10.2 years, 128 women), including 172 with cirrhosis, were included. Based CT/MRI follow-up (median 35 months, range 12–80 months), the overall cumulative incidence of developing a nodule was 10.5%. Cumulative incidence of nodule development was: 0.5% at 6–9 months and 2.1% at 12 ± 3 months, including one LR-4 nodule, one LR-M nodule, and two LR-3 nodules. The cumulative incidence of clinically significant nodule development was 1.1% at 9–15 months. 70% (143/204) of patients also underwent at least one US follow-up, and no patient developed a positive US examination following index negative MRI.

Conclusion

Clinically significant liver nodules develop in 1.1% of at-risk patients in the first year following negative MRI. While ongoing surveillance is necessary for at-risk patients, our study suggests than longer surveillance intervals after a negative MRI may be reasonable and that further research is needed to explore this possibility.

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Data availability

The data that support the findings of this study are available from the corresponding author.

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Funding

No industry funding was used to support the project.

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Authors and Affiliations

  1. Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC, 27710, USA

    Islam H. Zaki, Erin Shropshire, Benjamin Wildman-Tobriner, Daniele Marin, Rajan T. Gupta, Redon C. Nelson & Mustafa R. Bashir

  2. Center for Advanced Magnetic Resonance Development (CAMRD), Duke University Medical Center, Box 3808, Durham, NC, 27710, USA

    Islam H. Zaki & Mustafa R. Bashir

  3. Division of Gastroenterology, Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA

    Mustafa R. Bashir

  4. Department of Biostatistics and Bioinformatics, Duke University School of Medicine, 2424 Erwin Road, Suite 1102 Hock Plaza, Box 2721, Durham, NC, 27710, USA

    Shuaiqi Zhang, Dong Xiao & Alaattin Erkanli

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  1. Islam H. Zaki
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Correspondence to Mustafa R. Bashir.

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Zaki, I.H., Shropshire, E., Zhang, S. et al. How frequently does hepatocellular carcinoma develop in at-risk patients with a negative liver MRI examination with intravenous Gadobenate dimeglumine?. Abdom Radiol 46, 969–978 (2021). https://doi.org/10.1007/s00261-020-02771-5

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  • DOI: https://doi.org/10.1007/s00261-020-02771-5

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