Christophe Aubé1,2, Frédéric Oberti2,3, Julie Lonjon4, Georges Pageaux5, Olivier Seror6,7,8, Giséle N'Kontchou9, Agnes Rode10, Sylvie Radenne11, Christophe Cassinotto12, Julien Vergniol13, Ivan Bricault14,15, Vincent Leroy16, Maxime Ronot17, Laurent Castera18,19, Sophie Michalak20, Maxime Esvan21,22, Valérie Vilgrain19,17. 1. Département de Radiologie, CHU d'Angers, Université Bretagne Loire, Angers, France. 2. Laboratoire HIFIH, Université Bretagne Loire, Université d'Angers, Angers, France. 3. Service de Gastroenterologie et Hépatologie, Université Bretagne Loire, CHU d'Angers, Angers, France. 4. Département de Radiologie, CHU Saint Eloi, Université de Montpellier, Montpellier, France. 5. Département d'hépatogastroentérologie, CHU Saint Eloi, Université de Montpellier, Montpellier, France. 6. Service de Radiologie, Hôpital Jean Verdier, Hôpitaux universitaires Paris-Seine-Saint-Denis, Assistance publique Hôpitaux de Paris, Bondy, France. 7. Unité mixte de Recherche 1162, Génomique fonctionnelle des Tumeurs solides, Institut National de la Santé et de la Recherche médicale, Paris, France. 8. Unité de Formation et de Recherche Santé Médecine et Biologie humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France. 9. Service d'hépato gastroentérologie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance publique Hôpitaux de Paris, Bondy, France. 10. Département de Radiologie, Hôpital de la Croix Rousse, CHU Lyon, Lyon, France. 11. Service d'hépatologie, Hôpital de la croix rousse, Unité INSERM 1052, CHU Lyon, Lyon, France. 12. Département d'imagerie diagnostique et interventionnelle, Hôpital Haut-Lévèque, CHU Bordeaux, Pessac, France. 13. Service Hépato-gastroentérologie, CHU de Bordeaux, Hôpital Haut-Lévêque, Pessac, France. 14. Département d'imagerie, Radiologie et imagerie médicale, CHU, Grenoble, France. 15. Laboratory of Techniques for Biomedical Engineering And Complexity Management - Informatics, Mathematics and Applications, Université Grenoble Alpes, Grenoble, France. 16. Service d'hépato gastroentérologie, University Hospital, Grenoble, France. 17. Département de Radiologie, Hôpital Beaujon, Hôpitaux Paris Nord Val de Seine (AP-HP), Clichy, France. 18. Service d'hépatologie, Hôpital Beaujon, Assistance Publique-Hopitaux de Paris, Clichy, France. 19. Université Paris Diderot, Sorbonne Paris Cité, CRI, U1149, Paris, France. 20. Département d'anatomopatologie, CHU d'Angers, LUNAM Université, Angers, France. 21. Assistance Publique - Hôpitaux de Paris, Hôpital européen Georges-Pompidou, Unité d'Épidémiologie et de Recherche Clinique, Paris, France. 22. INSERM, Centre d'Investigation Clinique 1418, module Épidémiologie Clinique, Paris, France.
Abstract
AIMS: To evaluate the diagnostic performance of CT, MRI and CEUS alone and in combination, for the diagnosis of HCC between 10 and 30 mm, in a large population of cirrhotic patients. PATIENTS AND METHODS: In a multicentre prospective trial, 442 patients have been enrolled. Within a month, CEUS, CT and MRI were performed for all patients. A composite algorithm was defined to obtain the more accurate gold standard. RESULTS: A total of 544 nodules in 381 patients have been retained for the performance analysis. Eighty-two percent of the patients were male, mean age was 62 years. For the 10-20 mm nodules (n=342), the sensitivity (Se) and specificity (Sp) for the diagnosis of HCC were, respectively, 70.6% and 83.2% for MRI, 67.9% and 76.8% for CT and 39.6% and 92.9% for CEUS. For the 20-30 mm nodules (n=202), the Se and Sp were, respectively, 72.3% and 89.4% for MRI, 71.6% and 93.6% for CT and 52.9% and 91.5% for CEUS. THE BEST COMBINATION FOR THE 10-20 MM NODULES WAS MRI + CT (SE: 55.1%, SP: 100.0%).: After a first inconclusive technique, CEUS as second image technique allowed the highest specificity with only a slight drop of sensitivity for 10-20 mm nodules and the highest sensitivity and specificity for 20-30 mm nodules. CONCLUSION: This large multicentre study validates the EASL/AASLD recommendations in daily practice. Specificity using CT or MRI in 10-20 mm HCC was low, but we do not recommend combined imaging at first as sensitivity would be very low. The best sequential approach combined MRI and CEUS.
AIMS: To evaluate the diagnostic performance of CT, MRI and CEUS alone and in combination, for the diagnosis of HCC between 10 and 30 mm, in a large population of cirrhotic patients. PATIENTS AND METHODS: In a multicentre prospective trial, 442 patients have been enrolled. Within a month, CEUS, CT and MRI were performed for all patients. A composite algorithm was defined to obtain the more accurate gold standard. RESULTS: A total of 544 nodules in 381 patients have been retained for the performance analysis. Eighty-two percent of the patients were male, mean age was 62 years. For the 10-20 mm nodules (n=342), the sensitivity (Se) and specificity (Sp) for the diagnosis of HCC were, respectively, 70.6% and 83.2% for MRI, 67.9% and 76.8% for CT and 39.6% and 92.9% for CEUS. For the 20-30 mm nodules (n=202), the Se and Sp were, respectively, 72.3% and 89.4% for MRI, 71.6% and 93.6% for CT and 52.9% and 91.5% for CEUS. THE BEST COMBINATION FOR THE 10-20 MM NODULES WAS MRI + CT (SE: 55.1%, SP: 100.0%).: After a first inconclusive technique, CEUS as second image technique allowed the highest specificity with only a slight drop of sensitivity for 10-20 mm nodules and the highest sensitivity and specificity for 20-30 mm nodules. CONCLUSION: This large multicentre study validates the EASL/AASLD recommendations in daily practice. Specificity using CT or MRI in 10-20 mm HCC was low, but we do not recommend combined imaging at first as sensitivity would be very low. The best sequential approach combined MRI and CEUS.
Authors: Ania Z Kielar; Victoria Chernyak; Mustafa R Bashir; Richard K Do; Kathryn J Fowler; Donald G Mitchell; Milena Cerny; Khaled M Elsayes; Cynthia Santillan; Aya Kamaya; Yuko Kono; Claude B Sirlin; An Tang Journal: J Magn Reson Imaging Date: 2018-04-06 Impact factor: 4.813
Authors: Saleh A Alqahtani; Faisal M Sanai; Ashwaq Alolayan; Faisal Abaalkhail; Hamad Alsuhaibani; Mazen Hassanain; Waleed Alhazzani; Abdullah Alsuhaibani; Abdullah Algarni; Alejandro Forner; Richard S Finn; Waleed K Al-Hamoudi Journal: Saudi J Gastroenterol Date: 2020-10 Impact factor: 2.485