Aims and objectives
To assess the use ofGd-EOB-DTPA MRI in patients with “atypical” HCC diagnosed at multiphase CT.
Methods and materials
Between November 2016 and December 2017 we recruited 51 consecutive patients with cirrhosis of the liver,
with a mean age of 63.23 years (41 males,
10 females),
with at least a “naïve” lesion showing atypical dynamics enhancement on multiphase CT scan (Revolution CT or Optima 660,
2ml/kg Iomeron®400).
All these patients underwent Gd-EOB-DTPA MRI and were prospectively enrolled.
MR study performed with 1.5 T equipment (Achieva,
version 2.6,
Philips Medical Systems,
DA Best,
The Netherlands) with Sense XL Torso 16-element phased array Torso,
using hepatospecific...
Results
The CT scan characterized 15 lesions as typical HCC (hypervascular lesion with wash-out),
while 75 lesions were found to be atypical for CT examination (hypervascular without wash-out,
category 1A,
or hypovascular with wash- out,
category 1B).
EOB-MRI was able to identify a total of 73 lesions typed as HCC,
of which 21 lesions had not been detected by the CT scan.
EOB-MRI was able to categorize 56/75 (75%) of lesions with atypical behavior in CT.
Of the 75 lesions with atypical behavior in TC: 39/75...
Conclusion
Gd-EOB MRIhas ultimately proved to be capable of providing the best diagnostic performance for the characterization and classification of the suspicious nodule for HCC in the cirrhotic liver.
In our series,
the only vascular criterion,
defined by the European guidelines,
is less sensitive than the multiparametricity of EOB-MRI in the diagnosis of HCC.
The further therapeutic implication of the method has been demonstrated by the "up-staging" of the patients that can determine with,
respect to the CT examination only.
Moreover,
given the greater diagnostic accuracy...
References
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European J Hepatol.
2001 Sep
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Proposal of a new diagnostic algorithm for hepatocellular carcinoma based on the Japanese guidelines but adapted to the Western world for patients under surveillance for chronic liver disease.
J Gastroenterol Hepatol.
2016 Jan
- European Association for the Study of the Liver,
Europea Organisation for Resarch and Treatment of Cancer.
EASL-EORTC clinicla practice...