Chong Hyun Suh1,2, Kyung Won Kim1, Junhee Pyo3, Jayoun Lee4, So Yeon Kim1, Seong Ho Park1. 1. 1 Department of Radiology and Research Institute of Radiology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Seoul, Republic of Korea. 2. 2 Department of Radiology, Namwon Medical Center, Namwon-si, Republic of Korea. 3. 3 Collaborating Center for Pharmaceutical Policy and Regulation, Department of Pharmaceutical Science, Utrecht University, Utrecht, The Netherlands. 4. 4 National Evidence-Based Healthcare Collaborating Agency, Seoul, Republic of Korea.
Abstract
OBJECTIVE: The purpose of this study is to evaluate the outcomes of hypovascular hypointense nodules in the hepatobiliary phase of gadoxetic acid-enhanced MRI and the risk factors for the hypervascular transformation of the nodules through a systematic review and meta-analysis. MATERIALS AND METHODS: We searched the Ovid-MEDLINE and EMBASE databases for published studies of hypovascular hypointense nodules in patients with chronic liver disease. The pooled proportions of the overall and cumulative incidence rates at 1, 2, and 3 years for the transformation of hypovascular hypointense nodules into hypervascular hepatocellular carcinomas (HCCs) were assessed by using random-effects modeling. Metaregression analysis was performed. RESULTS: Sixteen eligible studies with 944 patients and 1819 hypovascular hypointense nodules in total were included. The pooled overall rate of hypervascular transformation was 28.2% (95% CI, 22.7-33.6%; I2 = 87.46%). The pooled 1-, 2-, and 3-year cumulative incidence rates were 18.3% (95% CI, 9.2-27.4%), 25.2% (95% CI, 12.2-38.2%), and 30.3% (95% CI, 18.8-41.9%), respectively. The metaregression analysis revealed that the mean initial nodule size (cutoff value, 9 mm) was a significant factor affecting the heterogeneity of malignant transformation. CONCLUSION: Hypovascular hypointense nodules detected in the hepatobiliary phase of gadoxetic acid-enhanced MRI carry a significant potential of transforming into hypervascular HCCs. The size of nodules is a significant risk factor for hypervascular transformation.
OBJECTIVE: The purpose of this study is to evaluate the outcomes of hypovascular hypointense nodules in the hepatobiliary phase of gadoxetic acid-enhanced MRI and the risk factors for the hypervascular transformation of the nodules through a systematic review and meta-analysis. MATERIALS AND METHODS: We searched the Ovid-MEDLINE and EMBASE databases for published studies of hypovascular hypointense nodules in patients with chronic liver disease. The pooled proportions of the overall and cumulative incidence rates at 1, 2, and 3 years for the transformation of hypovascular hypointense nodules into hypervascular hepatocellular carcinomas (HCCs) were assessed by using random-effects modeling. Metaregression analysis was performed. RESULTS: Sixteen eligible studies with 944 patients and 1819 hypovascular hypointense nodules in total were included. The pooled overall rate of hypervascular transformation was 28.2% (95% CI, 22.7-33.6%; I2 = 87.46%). The pooled 1-, 2-, and 3-year cumulative incidence rates were 18.3% (95% CI, 9.2-27.4%), 25.2% (95% CI, 12.2-38.2%), and 30.3% (95% CI, 18.8-41.9%), respectively. The metaregression analysis revealed that the mean initial nodule size (cutoff value, 9 mm) was a significant factor affecting the heterogeneity of malignant transformation. CONCLUSION:Hypovascular hypointense nodules detected in the hepatobiliary phase of gadoxetic acid-enhanced MRI carry a significant potential of transforming into hypervascular HCCs. The size of nodules is a significant risk factor for hypervascular transformation.
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: Tae-Hyung Kim; Sungmin Woo; Sangwon Han; Chong Hyun Suh; Richard Kinh Gian Do; Jeong Min Lee Journal: Acad Radiol Date: 2020-09-20 Impact factor: 5.482
Authors: Dong Ho Lee; Jeong Min Lee; Mi Hye Yu; Bo Yun Hur; Nam-Joon Yi; Kwang-Woong Lee; Kyung-Suk Suh; Jung-Hwan Yoon; Yoon Jun Kim; Jeong-Hoon Lee; Su Jong Yu; Joon Koo Han Journal: Eur Radiol Date: 2019-01-14 Impact factor: 5.315