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