Detection of Hypervascular Hepatocellular Carcinoma: Comparison between Gadoxetic Acid-enhanced Magnetic Resonance Imaging and Diffusion Weighted Image
Abstract
Objective: The purpose of the study was to determine if the gadoxetic acid-enhanced magnetic resonance (MR) imaging plus dynamic scans and diffusion-weighted (DW) imaging plus dynamic scans gives more sensitivity and accuracy in the diagnosis of hepatocellular carcinomas (HCCs).
Methods: The institutional review board approved this retrospective study and waived the requirement for informed consent. Forty-five cirrhotic patients with 101 HCCs underwent gadoxetic acid-enhanced MR-imaging and DW imaging at 3.0T between January 2012 and November 2013. Two sets of images were analyzed independently by two observers to detect HCC: a gadoxetic acid set (unenhanced, early dynamic, delayed and hepatobiliary phases) and a DW imaging set (unenhanced, early dynamic, delayed and DWI). Diagnostic accuracy, sensitivity, specificity, positive and negative predictive values were calculated.
Results: The accuracy of the gadoxetic acid set and DWI set were 88.5-89.2 and 62.8, respectively. The sensitivi- ty of the gadoxetic acid set and DWI set were 93-96 and 57.4-64.3, respectively. No significant difference of positive predictive value between the two datasets was reported.
Conclusion: The gadoxetic acid set give more diagnostic accuracy and sensitivity to detect HCCs than the DWI set.
Keywords: Hepatocellular carcinoma, gadoxetic acid-enhanced magnetic resonance imaging, diffusion weighted image
Siriraj Med J 2014;66:120-126
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