Arterial enhancing-only nodules less than 2 cm in diameter in patients with liver cirrhosis: Predictors of hepatocellular carcinoma diagnosis on gadobenate dimeglumine-enhanced MR imaging

Emilio Quaia, Riccardo Pizzolato, Luca De Paoli, Roberta Angileri, Maja Ukmar, Maria Assunta Cova

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To assess whether gadobenate dimeglumine (Gd-BOPTA)-enhanced MR imaging could predict hepatocellular carcinoma (HCC) diagnosis in small arterial enhancing-only nodules detected by contrast-enhanced computed tomography (CT) in patients with liver cirrhosis.

MATERIALS AND METHODS: We prospectively recruited 125 cirrhotic patients (67 males, and 58 females; age: 68 ± 12.36 years) with 151 small (<2 cm in diameter) arterial enhancing-only nodules identified by contrast-enhanced CT. All patients were scanned by MR imaging before and after Gd-BOPTA injection during the hepatic arterial phase (HAP), portal venous phase (PVP), equilibrium phase (EP), and hepatobiliary phase (HP). Nodule characterization was based on reference imaging criteria (n = 29 nodules), follow-up (n = 105), or histology (n = 17). Two radiologists (5 and 10 years experience) analyzed the MR images, and logistic regression was conducted to assess how well MR imaging findings could predict HCC diagnosis.

RESULTS: Final diagnoses included 115 benign nodules and 36 HCCs. Nodule T2 hyperintensity, T1 hypointensity, PVP-EP hypointensity, and HP hypointensity were the best predictors of HCC on univariate analysis. Nodule T2 hyperintensity, T1 hypointensity, and HP hypointensity, were independent predictors of HCC on multivariate analysis.

CONCLUSION: Gd-BOPTA-enhanced MR imaging provides imaging findings which may predict a diagnosis of HCC in small arterial enhancing-only nodules in cirrhotic patients.

Original languageEnglish
Pages (from-to)892-902
Number of pages11
JournalJournal of Magnetic Resonance Imaging
Volume37
Issue number4
DOIs
Publication statusPublished - Apr 2013

Keywords

  • Aged
  • Aged, 80 and over
  • Arteries
  • Carcinoma, Hepatocellular
  • Cell Transformation, Neoplastic
  • Contrast Media
  • Female
  • Focal Nodular Hyperplasia
  • Humans
  • Image Enhancement
  • Image Interpretation, Computer-Assisted
  • Liver
  • Liver Cirrhosis
  • Liver Neoplasms
  • Magnetic Resonance Imaging
  • Male
  • Meglumine
  • Middle Aged
  • Organometallic Compounds
  • Predictive Value of Tests
  • Prospective Studies

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