Abstract
Purpose
To compare diffusion-weighted imaging (DWI) and gadolinium ethoxybenzyl diethylenetriaminepentaacetic
acid (Gd-EOB-DTPA) magnetic resonance imaging (MRI) in the evaluation of hepatocellular
carcinoma (HCC) and nodules at high risk of HCC transformation.
Materials and methods
We evaluated nodules’ size, vascular pattern, and signal intensity on hepatobiliary
phase images and on DWI of 105 nodules (41 cirrhotic patients).
Results
A total of 35/66 HCCs identified on Gd-EOB-DTPA MRI showed hyperintensity on DWI.
A total of 25/39 nodules (hypovascular and hypointense nodule on hepatobiliary phase
images) progressed to HCC (higher risk for nodules ≥10 mm in size and hyperintense on DWI, P<.05).
Conclusion
Gd-EOB-DTPA MRI demonstrated a significant role in the identification of nodule at
higher risk of HCC transformation, and hyperintensity on DWI was associated with progression
to HCC.
Keywords
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References
- Hepatocellular carcinoma: epidemiology, risk factors and pathogenesis.World J Gastroenterol. 2008; 14: 4300-4308https://doi.org/10.3748/wig.14.4300
- Dysplastic nodules frequently develop into hepatocellular carcinoma in patients with chronic viral hepatitis and cirrhosis.Cancer. 2006; 106: 636-647https://doi.org/10.1002/cncr.21607
- Prognostic prediction and treatment strategy in hepatocellular carcinoma.Hepatology. 2002; 35: 519-524https://doi.org/10.1053/jhep.2002.32089
- Natural history of hepatocellular carcinoma including fibrolamellar and hepato-cholangiocarcinoma variants.J Gastroenterol Hepatol. 2002; 17: 401-405https://doi.org/10.1046/j.1440-1746.2002.02734.x
- Management of hepatocellular carcinoma: an update.Hepatology. 2011; 53: 1020-1022https://doi.org/10.1002/hep.24199
- Diagnosis of hepatocellular carcinoma.Diagn Interv Imaging. 2014; 95: 709-719https://doi.org/10.1080/13651820410024049
- MR imaging of hypervascular liver masses: a review of current techniques.Radiographics. 2009; 29: 385-402https://doi.org/10.1148/rg.292085123
- Gadoxetate acid-enhanced MR imaging for HCC: a review for clinicians.Int J Hepatol. 2011; 489342https://doi.org/10.4061/2011/489342
- Consensus report of the 4th international forum for gadolinium-ethoxybenzyl-diethylenetri-amine pentaacetic acid magnetic resonance imaging.Korean J Radiol. 2011; 12: 403-415https://doi.org/10.3348/kjr.2011.12.4.403
- Primovist, Eovist: what to expect?.J Hepatol. 2012; 57: 421-429https://doi.org/10.1016/j.jhep.2012.01.031
- Contribution of diffusion-weighted MRI to the differential diagnosis of hepatic masses.Diagn Interv Radiol. 2007; 13: 81-86
- Added value of breathhold diffusion-weighted MRI in detection of small hepatocellular carcinoma lesions compared with dynamic contrast-enhanced MRI alone using receiver operating characteristic curve analysis.J Magn Reson Imaging. 2009; 29: 341-349https://doi.org/10.1002/jmri.21650
- Impact of diffusion-weighted MR imaging on the characterization of small hepatocellular carcinoma in the cirrhotic liver.Magn Reson Imaging. 2012; 30: 656-665https://doi.org/10.1016/j.mri.2012.01.002
- Diffusion-weighted MR imaging of the liver.Radiology. 2010; 254: 47-66https://doi.org/10.1148/radiol.09090021
- Diffusion-weighted MRI of the liver—interpretative pearls and pitfalls.Clin Radiol. 2012; ([pii: S0009-9260(12)00435-7]): 13https://doi.org/10.1016/j.crad.2012.08.008
- Effect of Gd-EOB-DTPA on T2-weighted and diffusion-weighted images for the diagnosis of hepatocellular carcinoma.J Magn Reson Imaging. 2010; 32: 229-234https://doi.org/10.1002/jmri.22219
- MR imaging of hepatocellular carcinoma: relationship between lesion size and imaging findings, including signal intensity and dynamic enhancement patterns.J Magn Reson Imaging. 2007; 26: 1548-1555
- Small hepatocellular carcinomas in cirrhosis: differences in contrast enhancement effects between helical CT and MR imaging during multiphasic dynamic imaging.Magn Reson Imaging. 2008; 26: 65-71
- Expression of AOTP1B3 determines uptake of Gd-EOB- DTPA in hepatocellular carcinoma.J Gastroenterol. 2009; 44: 793-798
- Hepatocellular carcinoma: hepatocyte-selective enhancement at gadoxetic acid–enhanced MR imaging—correlation with expression of sinusoidal and canalicular transporters and bile accumulation.Radiology. 2010; 255: 824-833
- Imaging benign hepatocellular tumors: atypical forms and diagnostic traps.Diagn Interv Imaging. 2013; 94: 677-695
- Detection of liver malignancy with gadoxetic acid-enhanced MRI: is addition of diffusion-weighted MRI beneficial?.Clin Radiol. 2011; 66: 489-496https://doi.org/10.1016/j.crad.2010.09.007
- Detection of colorectal hepatic metastases using MnDPDP MR imaging and diffusion-weighted imaging (DWI) alone and in combination.Eur Radiol. 2008; 18: 903-910https://doi.org/10.1007/s00330-007-0847-z
- Small hepatocellular carcinomas: improved sensitivity by combining gadoxetic acid-enhanced and diffusion-weighted MR imaging patterns.Radiology. 2012; 264: 761-770
- Tumor size predicts vascular invasion and histologic grade: implications for selection of surgical treatment for hepatocellular carcinoma.Liver Transpl. 2005; 11: 1086-1092
- Prediction of poorly differentiated hepatocellular carcinoma using contrast computed tomography.Cancer Imaging. 2014; 14: 7
- Diffusion-weighted imaging of surgically resected hepatocellular carcinoma: imaging characteristics and relationship among signal intensity, apparent diffusion coefficient, and histopathologic grade.AJR Am J Roentgenol. 2009; 193: 438-444https://doi.org/10.2214/AJR.08.1424
- High-b-value diffusion-weighted MR imaging of hepatocellular lesions: estimation of grade of malignancy of hepatocellular carcinoma.J Magn Reson Imaging. 2009; 30: 1005-1011https://doi.org/10.1002/jmri.21931
- Gd-EOB-DTPA-enhanced magnetic resonance images of hepatocellular carcinoma: correlation with histological grading and portal blood flow.Eur Radiol. 2010; 20: 2405-2413https://doi.org/10.1007/s00330-010-1812-9
- Imaging study of early hepatocellular carcinoma: usefulness of gadoxetic acid-enhanced MR imaging.Radiology. 2011; 261: 834-844https://doi.org/10.1148/radiol.11101840
- Evolution of hypointense hepatocellular nodules observed only in the hepatobiliary phase of gadoxetate disodium-enhanced MRI.AJR Am J Roentgenol. 2011; 197: 58-63https://doi.org/10.2214/AJR.10.5390
- Detection of hepatocellular carcinoma: comparison of ferumoxides-enhanced and gadolinium-enhanced dynamic three-dimensional volume interpolated breath-hold MR imaging.Eur Radiol. 2005; 15: 140-147
- Gadoxetic acid-enhanced hepatobiliary phase MRI and high-b-value diffusion-weighted imaging to distinguish well-differentiated hepatocellular carcinomas from benign nodules in patients with chronic liver disease.AJR Am J Roentgenol. 2011; 97: W868-W875https://doi.org/10.2214/AJR.10.6237
- Hypovascular hypointense nodules on hepatobiliary phase gadoxetic acid-enhanced MR images in patients with cirrhosis: potential of DW imaging in predicting progression to hypervascular HCC.Radiology. 2012; 265: 104-114https://doi.org/10.1148/radiol.12112649
- Diffusion-weighted MRI provides additional value to conventional dynamic contrast-enhanced MRI for detection of hepatocellular carcinoma.Eur Radiol. 2009; 19: 2456-2466https://doi.org/10.1007/s00330-009-1431-5
Article info
Publication history
Published online: January 06, 2015
Accepted:
December 20,
2014
Received in revised form:
November 13,
2014
Received:
August 16,
2014
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
