Evidence of diagnostic enhancement pattern in hepatocellular carcinoma nodules ≤2 cm according to the AASLD/EASL revised criteria

Emilio Quaia, Luca De Paoli, Roberta Angileri, Riccardo Pizzolato, Biagio Cabibbo, Maria Assunta Cova

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To define the percentage of small (≤2 cm) hepatocellular carcinoma (HCC) nodules showing the diagnostic enhancement pattern at CEUS, computed tomography (CT), and gadobenate dimeglumine (Gd-BOPTA)-enhanced magnetic resonance (MR) imaging.

METHODS: 42 cirrhotic patients (26 male, 16 female; 67 ± 12 years) with 46 biopsy-proven HCCs ≤2 cm were included. Each HCC was scanned by CEUS, contrast-enhanced CT, and Gd-BOPTA-enhanced MR imaging. Nodule enhancement was evaluated by two readers. Independent analysis was followed by consensual analysis and the proportion of HCCs with the diagnostic enhancement pattern (nodule hyperenhancing on hepatic arterial phase and hypoenhancing on portal venous-late phase) on CEUS, CT, and MR imaging was compared by chi-square test.

RESULTS: Very good inter-reader agreement was observed on hepatic arterial phase and portal venous-late phase: CEUS, k = 0.89 and 0.85; CT, k = 0.91 and 0.88; MR imaging, k = 0.96 and 0.94. CEUS and CT did not differ in the percentage of HCC nodules with a diagnostic enhancement pattern (18/46 and 16/46; P = 0.66), while MR imaging revealed the diagnostic pattern in higher percentage of nodules (29/46; P = 0.012) in comparison to CEUS and CT.

CONCLUSIONS: CEUS and contrast-enhanced CT did not differ in the percentage of small HCC nodules with diagnostic enhancement pattern, while Gd-BOPTA-enhanced MR imaging revealed the diagnostic pattern in a higher nodule number in comparison to CEUS and CT.

Original languageEnglish
Pages (from-to)1245-53
Number of pages9
JournalAbdominal Imaging
Volume38
Issue number6
DOIs
Publication statusPublished - Dec 2013

Keywords

  • Aged
  • Biopsy
  • Carcinoma, Hepatocellular
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted
  • Iohexol
  • Iopamidol
  • Liver Cirrhosis
  • Liver Neoplasms
  • Magnetic Resonance Imaging
  • Male
  • Meglumine
  • Middle Aged
  • Organometallic Compounds
  • Phospholipids
  • Reproducibility of Results
  • Retrospective Studies
  • Subtraction Technique
  • Sulfur Hexafluoride
  • Tomography, X-Ray Computed

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