Rakhee Gawande1, Hamed Jalaeian2, Eric Niendorf3, Deniz Olgun4, Luke Krystosek5, Nathan Rubin6, Benjamin Spilseth7. 1. Johns Hopkins University, 601 N Caroline Street, Radiology, JHOC 3235-A, Baltimore, MD, 21287-0010, United States. Electronic address: rgawand1@jhmi.edu. 2. Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, United States. Electronic address: Hamed.jalaeianmd@baystatehealth.org. 3. Mayo Healthcare System, Department of Radiology, 1221 Whipple St., Eau Claire, WI, 54703, United States. Electronic address: niendorf.eric@mayo.edu. 4. Istanbul University Cerrahpasa Medical Faculty, Radiology Department, Cerrahpasa Mahallesi Kocamustafapasa, Fatih, İstanbul, 34098, Turkey. Electronic address: dcolgun@umn.edu. 5. University of Minnesota Radiology Department, MMC 292, 420 Delaware St. SE, Minneapolis, MN, 55455, United States. Electronic address: krys0024@umn.edu. 6. Biostatistics Core, Masonic Cancer Center, University of Minnesota, 717 Delaware Street SE Rm 140-08, Minneapolis, MN, 55414, United States. Electronic address: rubi0169@umn.edu. 7. University of Minnesota, 420 Delaware Street S.E. B234, Mayo Memorial Building MMC 292, Minneapolis, MN, 55455, United States. Electronic address: spil0042@umn.edu.
Abstract
PURPOSE: To evaluate MR imaging parameters including quantitative multiphasic post-contrast enhancement with subtraction and qualitative diffusion weighted imaging (DWI) in differentiating benign versus malignant portal venous thrombosis (PVT) in patients with hepatocellular carcinoma (HCC). METHOD: Radiology reports over a 6-year period ending February 2016 were searched for key words indicating presence of both HCC and PVT on abdominal MRI. 39 patients were identified with PVT characterized as benign or malignant based on pathologic data or serial imaging growth criteria. Image review was performed by two subspecialized radiologists blinded to the diagnosis and medical chart. Signal intensity for regions of interest were recorded within the portal vein thrombus as well as the portal vein on pre-contrast and dynamic post-contrast phases without and with subtraction. Qualitative parameters for DWI and presence of PV expansion were also evaluated. RESULTS: Percent enhancement generated high area under the curve (AUC) for both readers on all non-subtraction phases: arterial (0.95/0.98), portal venous (0.97/0.97) and delayed phase (0.96/0.99) and subtraction phases: arterial (0.91/0.96), portal venous (0.94/0.99) and delayed phases (0.96/0.97). Statistically significant differences were observed between benign and malignant PVT for both readers for PV expansion (p= <0.001/0.006). No qualitative DWI parameter reached statistical significance for both readers. CONCLUSIONS: Post-contrast and subtraction MRI can reliably distinguish malignant from benign PVT in patients with HCC using subtracted or non-subtracted images and at arterial, portal venous, or delayed phase timing.
PURPOSE: To evaluate MR imaging parameters including quantitative multiphasic post-contrast enhancement with subtraction and qualitative diffusion weighted imaging (DWI) in differentiating benign versus malignant portal venous thrombosis (PVT) in patients with hepatocellular carcinoma (HCC). METHOD: Radiology reports over a 6-year period ending February 2016 were searched for key words indicating presence of both HCC and PVT on abdominal MRI. 39 patients were identified with PVT characterized as benign or malignant based on pathologic data or serial imaging growth criteria. Image review was performed by two subspecialized radiologists blinded to the diagnosis and medical chart. Signal intensity for regions of interest were recorded within the portal vein thrombus as well as the portal vein on pre-contrast and dynamic post-contrast phases without and with subtraction. Qualitative parameters for DWI and presence of PV expansion were also evaluated. RESULTS: Percent enhancement generated high area under the curve (AUC) for both readers on all non-subtraction phases: arterial (0.95/0.98), portal venous (0.97/0.97) and delayed phase (0.96/0.99) and subtraction phases: arterial (0.91/0.96), portal venous (0.94/0.99) and delayed phases (0.96/0.97). Statistically significant differences were observed between benign and malignant PVT for both readers for PV expansion (p= <0.001/0.006). No qualitative DWI parameter reached statistical significance for both readers. CONCLUSIONS: Post-contrast and subtraction MRI can reliably distinguish malignant from benign PVT in patients with HCC using subtracted or non-subtracted images and at arterial, portal venous, or delayed phase timing.
Authors: Mats Ogren; David Bergqvist; Martin Björck; Stefan Acosta; Henry Eriksson; Nils H Sternby Journal: World J Gastroenterol Date: 2006-04-07 Impact factor: 5.742
Authors: Victoria Chernyak; Kathryn J Fowler; Aya Kamaya; Ania Z Kielar; Khaled M Elsayes; Mustafa R Bashir; Yuko Kono; Richard K Do; Donald G Mitchell; Amit G Singal; An Tang; Claude B Sirlin Journal: Radiology Date: 2018-09-25 Impact factor: 11.105