Performance of Gd‑EOB‑DTPA‑enhanced MRI for the diagnosis of LI‑RADS 4 category hepatocellular carcinoma nodules with different diameters

Tang,Qi; Ma,Cong

doi:10.3892/ol.2018.8884

Performance of Gd‑EOB‑DTPA‑enhanced MRI for the diagnosis of LI‑RADS 4 category hepatocellular carcinoma nodules with different diameters

Authors:
- Qi Tang
- Cong Ma
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Affiliations: Department of Surgery, The Second XiangYa Hospital of Central South University, Changsha, Hunan 410011, P.R. China, Department of Radiology, The Second XiangYa Hospital of Central South University, Changsha, Hunan 410011, P.R. China
Published online on: June 4, 2018 https://doi.org/10.3892/ol.2018.8884
Pages: 2725-2731

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Abstract

In 2011, the American College of Radiology released a standardized reporting and data collection system, named Liver Imaging Reporting and Data System (LI‑RADS), to improve the consistency of diagnostic imaging examinations of hepatocellular carcinoma (HCC). When the LI‑RADS guideline was updated in 2014, hepatobiliary contrast agents, including gadoxetate acid (Gd‑EOB‑DTPA), were incorporated into the system. However, the diagnostic performance of Gd‑EOB‑DTPA‑enhanced magnetic resonance imaging (MRI) for nodules of different diameters has not been addressed. In the present study, a total of 263 LI‑RADS 4 category hepatic nodules were examined blindly and independently by two radiologists. All nodules were divided into two datasets: Set 1 (n=86) that included nodules with iso/hypo‑intensity in the arterial phase (HCC, n=42; non‑HCC, n=44) and set 2 (n=177) that included nodules with hyper‑intensity in the arterial phase (HCC, n=131; non‑HCC, n=46). The diagnostic performance of Gd‑EOB‑DTPA‑enhanced MRI for evaluation of nodules with different diameters was evaluated. The present study revealed that the diagnostic performance of Gd‑EOB‑enhanced MRI of larger nodules (>2 cm) was higher compared with (<2 cm) smaller nodules. The FPR of large nodules (>2 cm) with a hypervascular pattern was lower compared with smaller nodules (<2 cm) with hypovascular pattern. In conclusion, Gd‑EOB‑enhanced MRI is useful for the diagnosis of HCC where hypervascular LI‑RADS 4 nodules are >2 cm in diameter. However, Gd‑EOB‑enhanced MRI may be of limited use for the assessment of nodules that <20 mm due to low diagnostic performance and high FPR.

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