• Hiroyuki Akai, Izuru Matsuda, Shigeru Kiryu, Taku Tajima, Hidemasa Takao, Yasushi Watanabe, Hiroshi Imamura, Norihiro Kokudo, Masaaki Akahane, and Kuni Ohtomo.
• Department of Radiology, Graduate School of Medicine, University of Tokyo, and Department of Radiological Technology, The University of Tokyo Hospital, Tokyo 113-8655, Japan. hakai-tky@umin.ac.jp
• Eur J Radiol. 2012 Nov 1; 81 (11): 2973-7.

PurposeTo investigate the natural outcome and clinical implication of hypointense lesions in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI.Materials And MethodsForty patients underwent Gd-EOB-DTPA-enhanced MRI for preoperative evaluation of HCC. Hypointense lesions in the hepatobiliary phase that were hypovascular 5mm of more were extracted for follow-up. We performed a longitudinal study retrospectively for these lesions regardless of whether classical HCC developed or emerged in a different area from that of the lesions being followed.ResultsThirty one patients displayed 130 hypointense lesions on MRI and only nine showed no hypointense lesions. In total, 17 (13.1%) of 130 hypointense lesions on MRI developed into classical HCC. The cumulative rates for these lesions to develop into classical HCC were 3.2% at 1 year, 11.1% at 2 years and 15.9% at 3 years. The total occurrence rates of classical HCC (25.8% at 1 year, 52.6% at 2 years and 76.4% at 3 years) were higher compared to those regarding only occurrence of classical HCC from hypointense lesions on MRI (10.0% at 1 year, 35.6% at 2 years and 44.6% at 3 years), although no significant difference was observed (p=0.073).ConclusionsHypointense lesions that are detected in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI have some malignant potential, although treating these lesions aggressively in patients who already have HCC may be too severe.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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