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Diagnostic accuracy for macroscopic classification of nodular hepatocellular carcinoma: comparison of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging and angiography-assisted computed tomography

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

The macroscopic type of hepatocellular carcinoma (HCC) is a predictor of prognosis. We clarified the diagnostic value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)–enhanced magnetic resonance imaging (MRI) in the macroscopic classification of nodular hepatocellular carcinoma (HCC) as compared to angiography-assisted computed tomography (CT).

Methods

A total of 71 surgically resected nodular HCCs with a maximum diameter of ≤5 cm were investigated. HCCs were evaluated preoperatively using Gd-EOB-DTPA–enhanced MRI and angiography-assisted CT. HCCs were pathologically classified as simple nodular (SN), SN with extranodular growth (SN-EG), or confluent multinodular (CMN). SN-EG and CMN were grouped as non-SN. Five readers independently reviewed the images using a five-point scale. We examined the accuracy of both imaging modalities in differentiating between SN and non-SN HCC.

Results

Overall, the area under the receiver operating characteristic curve (A z ) for the diagnosis of non-SN did not differ between Gd-EOB-DTPA–enhanced MRI and angiography-assisted CT [0.879 (95 % confidence interval (CI), 0.779–0.937) and 0.845 (95 % CI, 0.723–0.919), respectively]. For HCCs >2 cm, the A z for Gd-EOB-DTPA–enhanced MRI was greater than 0.9. The sensitivity, specificity, and accuracy of Gd-EOB-DTPA–enhanced MRI for identifying non-SN were equal to or higher than values with angiography-assisted CT in all three categories (all tumors, ≤2 cm, and >2 cm), but the differences were not statistically significant.

Conclusions

Using Gd-EOB-DTPA–enhanced MRI to assess the macroscopic findings in nodular HCC was equal or superior to using angiography-assisted CT.

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Abbreviations

HCC:

Hepatocellular carcinoma

CT:

Computed tomography

CTAP:

CT during arterial portography

CTHA:

CT during hepatic arteriography

Gd-EOB-DTPA:

Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid

MRI:

Magnetic resonance imaging

SN:

Simple nodular

SN-EG:

Simple nodular with extranodular growth

CMN:

Confluent multinodular

ROC:

Receiver operating characteristic

PPV:

Positive predictive value

NPV:

Negative predictive value

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan

    Toshifumi Tada, Takashi Kumada, Hidenori Toyoda & Takanori Ito

  2. Department of Radiology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan

    Yasuhiro Sone

  3. Department of Pathological Diagnosis, Ogaki Municipal Hospital, Ogaki, Gifu, Japan

    Seiji Okuda

  4. Department of Imaging Diagnosis, Ogaki Municipal Hospital, Ogaki, Gifu, Japan

    Sadanobu Ogawa

  5. Department of Gastroenterology, Ikeda Municipal Hospital, Ikeda, Osaka, Japan

    Takumi Igura & Yasuharu Imai

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  1. Toshifumi Tada
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  2. Takashi Kumada
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Correspondence to Toshifumi Tada.

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Tada, T., Kumada, T., Toyoda, H. et al. Diagnostic accuracy for macroscopic classification of nodular hepatocellular carcinoma: comparison of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging and angiography-assisted computed tomography. J Gastroenterol 50, 85–94 (2015). https://doi.org/10.1007/s00535-014-0947-x

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  • DOI: https://doi.org/10.1007/s00535-014-0947-x

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