Keywords:
Abdomen, Oncology, Gastrointestinal tract, CT, MR, Staging, Cancer, Cirrhosis
Authors:
S. Fiore, E. Caramia, M. Gatti, L. J. Pavan, S. Molinaro, A. Depaoli, R. Faletti, P. Fonio; Turin/IT
DOI:
10.1594/ecr2018/C-1169
Methods and materials
We enrolled the first 26 consecutive cirrhotic patients (mean age: 63,4 years) that previously had undergone a multiphasic CT (Revolution CT or Optima 660,
Ge Healthcare) examination showing a focal hepatic lesion suspicious for HCC.
CT protocol included basal study and arterial,
portal and late phase scan after intravenous injection of iodine contrast medium (Iomeron 400).
After one month patients underwent a Gd-EOB-DTPA (Primovist) MRI (Achieva 1,5 Tesla,
Philips).
T1- (in- and out-of phase),
T2-,
dynamic multipashic T1- (with fat suppression) and diffusion (DWI) weighted axial imaging was realized on all patients,
followed by a ultra-late hepatobiliary phase axial sequence,
20 minutes after contrast medium infusion.
Lesions detected by CT were classified as atypical HCC in case of wash-in without wash-out (category 1A) or wash-out without wash-in (1B); lesions detected by MRI were classified as atypical HCC in case of wash-in and hypointensity in hepatobiliary phase without wash-out (2A) or wash-out without wash-in,
hypointensity in hepato-biliary phase and signal increase in DWI (2B).
Atypical lesions were confirmed by histology (biopsy or liver transplantation).