Hepatocellular Carcinoma Lesion Characterization: Single-Institution Clinical Performance Review of Multiphase Gadolinium-enhanced MR Imaging-Comparison to Prior Same-Center Results after MR Systems Improvements

被引:45
作者
Becker-Weidman, David J. S. [1 ]
Kalb, Bobby [1 ]
Sharma, Puneet [1 ]
Kitajima, Hiroumi D. [1 ]
Lurie, Christina R. [1 ]
Chen, Zhengjia [5 ]
Spivey, James R. [2 ]
Knechtle, Stuart J. [3 ]
Hanish, Steven I. [3 ]
Adsay, N. Volkan [4 ]
Farris, Alton B., III [4 ]
Martin, Diego R. [1 ]
机构
[1] Emory Univ, Sch Med, Dept Radiol, Atlanta, GA 30322 USA
[2] Emory Univ, Sch Med, Dept Med, Atlanta, GA USA
[3] Emory Univ, Sch Med, Dept Surg, Atlanta, GA 30322 USA
[4] Emory Univ, Sch Med, Dept Pathol, Atlanta, GA 30322 USA
[5] Emory Univ, Sch Publ Hlth, Dept Biostat & Bioinformat, Atlanta, GA USA
关键词
NEEDLE-TRACT IMPLANTATION; LIVER-TRANSPLANTATION; RISK-FACTORS; CT; CIRRHOSIS; NODULES; BIOPSY; SURVEILLANCE; OPTIMIZATION; MANAGEMENT;
D O I
10.1148/radiol.11110157
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
100231 [临床病理学]; 100902 [航空航天医学];
摘要
Purpose: To measure diagnostic performance in the detection of hepatocellular carcinoma (HCC) by using the most recent technology and multiphase gadolinium-enhanced magnetic resonance (MR) imaging and to compare with earlier results at the same institution. Materials and Methods: This retrospective study was institutional review board approved and HIPAA compliant. Informed consent was obtained. Between January 2008 and April 2010, 101 patients underwent liver transplantation and pretransplantation abdominal MR imaging within 90 days. Prospective image interpretations from the clinical record were reviewed for documentation of HCC, including size, number, arid location. Liver explant histologic examination provided the reference standard for lesion analysis and was performed in axial gross slices in conjunction with the MR imaging report for direct comparison. Tumors were categorized according to size (>= 2 cm or <2 cm), and MR imaging detection sensitivity, specificity, predictive values, and accuracy were calculated according to category. The Fisher exact test was used to compare results from this study against prior reported results. Results: Thirty-five (34.7%) of 101 patients had HCC at explant analysis. Patient-based analysis of all lesions showed a sensitivity and specificity of 97.1% (34 of 35) and 100% (66 of 66), respectively. For lesions 2 cm or larger, MR imaging had a sensitivity and specificity of 100% (23 of 23) and 100% (78 of 78), respectively. For lesions smaller than 2 cm, MR imaging had a sensitivity and specificity of 82.6% (19 of 23) and 100% (78 of 78), respectively. Lesion-based sensitivity for all tumors was 91.4% (53 of 58) in the current study, compared with 77.8% in 2007 (P = .07). For lesions smaller than 2 cm, the sensitivity was 87.5% (28 of 32) in the current study, compared with 55.6% previously (P = .02). Conclusion: MR imaging remains a highly accurate diagnostic method for the preoperative evaluation of UGC, and detection of small (<2 cm) tumors has been significantly improved compared with that of earlier studies. (C) RSNA, 2011
引用
收藏
页码:824 / 833
页数:10
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