Literature DB >> 18094293

Double-contrast MRI for accurate staging of hepatocellular carcinoma in patients with cirrhosis.

Robert F Hanna1, Norbert Kased, Sharon W Kwan, Anthony C Gamst, Agnes C Santosa, Tarek Hassanein, Claude B Sirlin.   

Abstract

OBJECTIVE: The aim of this study was to evaluate the accuracy of a double-contrast MRI protocol in staging of hepatocellular carcinoma (HCC) in patients with cirrhosis.
MATERIALS AND METHODS: This cross-sectional study was performed at a tertiary liver care center. Forty-eight patients with cirrhosis underwent double-contrast MRI for clinical care and liver transplantation. For each MRI examination, superparamagnetic iron oxide was infused, and 2D T2*-weighted spoiled gradient-recalled echo and T2-weighted echo-train spin-echo MR images were obtained for assessment of phagocytic function. Immediately afterward, a low-molecular-weight gadolinium compound was injected, and 3D T1-weighted spoiled gradient-recalled echo images were acquired dynamically for assessment of vascularity. Two blinded radiologists independently reviewed all MR images and assigned per-lesion and per-patient cancer confidence scores to determine the American Liver Tumor Study Group tumor stage. The imaging-based cancer scores and tumor stages were correlated with pathology reports. Performance parameters were computed for imaging-based measurements.
RESULTS: Of the 48 study subjects, 25 had HCC (three, T1; 18, T2; one, T3; one, T4a; two, T4b). In total, there were 37 HCC nodules. The accuracy of MRI in prediction of pathologic tumor stage was 81-85% depending on the radiologist. Per-patient and per-lesion sensitivity in the diagnosis of HCC were 96% and 81% for one radiologist and 96% and 89% for the other.
CONCLUSION: A double-contrast MRI protocol has high accuracy in staging of HCC in patients with cirrhosis.

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Year:  2008        PMID: 18094293     DOI: 10.2214/AJR.07.2595

Source DB:  PubMed          Journal:  AJR Am J Roentgenol        ISSN: 0361-803X            Impact factor:   3.959


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