Cecilia Besa1,2, Sara Lewis2, Pari V Pandharipande3, Jagpreet Chhatwal3, Amita Kamath2, Nancy Cooper2, Ashley Knight-Greenfield1, James S Babb4, Paolo Boffetta5, Norma Padron6, Claude B Sirlin7, Bachir Taouli8,9. 1. Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA. 2. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA. 3. Institute for Technology Assessment, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA. 4. Department of Radiology, New York University Langone Medical Center, New York, NY, USA. 5. Division of Cancer Prevention and Control, Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 6. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA. 7. Liver Imaging Group, Department of Radiology, University of California, San Diego, CA, USA. 8. Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Avenue, New York, NY, 10029, USA. bachir.taouli@mountsinai.org. 9. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA. bachir.taouli@mountsinai.org.
Abstract
PURPOSE: The purpose of this study was to evaluate the diagnostic performance of a "simulated" abbreviated MRI (AMRI) protocol using diffusion-weighted imaging (DWI) and T1-weighted (T1w) imaging obtained at the hepatobiliary phase (HBP) post gadoxetic acid injection alone and in combination, compared to dynamic contrast-enhanced (CE)-T1w imaging for the detection of hepatocellular carcinoma (HCC). METHODS: This was an IRB approved HIPAA compliant retrospective single institution study including patients with liver disease who underwent gadoxetic acid-enhanced MRI for HCC diagnosis. Three independent observers assessed 2 sets of images (full CE-set and AMRI including DWI+T1w-HBP). Diagnostic performance of T1w-HBP and DWI alone and in combination was compared to that of CE-set. All imaging sets included unenhanced T1w and T2w sequences. A preliminary analysis was performed to assess cost savings of AMRI protocol compared to a full MRI study. RESULTS: 174 patients including 62 with 80 HCCs were assessed. Equivalent per-patient sensitivity and negative predictive value (NPV) were observed for DWI (85.5% and 92.2%, pooled data) and T1w-HBP (89.8% and 94.2%) (P = 0.1-0.7), while these were significantly lower for the full AMRI protocol (DWI+T1w-HBP, 80.6% and 80%, P = 0.02) when compared to CE-set (90.3% and 94.9%). Higher specificity and positive predictive value were observed for CE-set vs. AMRI (P = 0.02). The estimated cost reduction of AMRI versus full MRI ranged between 30.7 and 49.0%. CONCLUSION: AMRI using DWI and T1w-HBP has a clinically acceptable sensitivity and NPV for HCC detection. This could serve as the basis for a future study assessing AMRI for HCC screening and surveillance.
PURPOSE: The purpose of this study was to evaluate the diagnostic performance of a "simulated" abbreviated MRI (AMRI) protocol using diffusion-weighted imaging (DWI) and T1-weighted (T1w) imaging obtained at the hepatobiliary phase (HBP) post gadoxetic acid injection alone and in combination, compared to dynamic contrast-enhanced (CE)-T1w imaging for the detection of hepatocellular carcinoma (HCC). METHODS: This was an IRB approved HIPAA compliant retrospective single institution study including patients with liver disease who underwent gadoxetic acid-enhanced MRI for HCC diagnosis. Three independent observers assessed 2 sets of images (full CE-set and AMRI including DWI+T1w-HBP). Diagnostic performance of T1w-HBP and DWI alone and in combination was compared to that of CE-set. All imaging sets included unenhanced T1w and T2w sequences. A preliminary analysis was performed to assess cost savings of AMRI protocol compared to a full MRI study. RESULTS: 174 patients including 62 with 80 HCCs were assessed. Equivalent per-patient sensitivity and negative predictive value (NPV) were observed for DWI (85.5% and 92.2%, pooled data) and T1w-HBP (89.8% and 94.2%) (P = 0.1-0.7), while these were significantly lower for the full AMRI protocol (DWI+T1w-HBP, 80.6% and 80%, P = 0.02) when compared to CE-set (90.3% and 94.9%). Higher specificity and positive predictive value were observed for CE-set vs. AMRI (P = 0.02). The estimated cost reduction of AMRI versus full MRI ranged between 30.7 and 49.0%. CONCLUSION: AMRI using DWI and T1w-HBP has a clinically acceptable sensitivity and NPV for HCC detection. This could serve as the basis for a future study assessing AMRI for HCC screening and surveillance.
Authors: Kristina Tzartzeva; Joseph Obi; Nicole E Rich; Neehar D Parikh; Jorge A Marrero; Adam Yopp; Akbar K Waljee; Amit G Singal Journal: Gastroenterology Date: 2018-02-06 Impact factor: 22.682
Authors: Julie Y An; Miguel A Peña; Guilherme M Cunha; Michael T Booker; Bachir Taouli; Takeshi Yokoo; Claude B Sirlin; Kathryn J Fowler Journal: Radiographics Date: 2020 Nov-Dec Impact factor: 5.333
Authors: Ryan L Brunsing; Dennis H Chen; Alexandra Schlein; Tanya Wolfson; Anthony Gamst; Adrija Mamidipalli; Naik Vietti Violi; Robert M Marks; Bachir Taouli; Rohit Loomba; Yuko Kono; Claude B Sirlin Journal: Radiol Imaging Cancer Date: 2019-11-29