• Andrew D Hardie, John W Nance, Daniel J Boulter, and Michael K Kizziah.
• Medical University of South Carolina, Department of Radiology and Radiological Science, 169 Ashley Avenue, Charleston, SC 29425, United States. andrewdhardie@gmail.com
• Eur J Radiol. 2011 Dec 1; 80 (3): e249-52.

BackgroundT2*-weighted MRI may represent a novel method for identifying hepatocellular carcinoma (HCC). The goal of this study was to assess the diagnostic accuracy of T2*-weighted MRI for HCC with liver explant correlation.Materials And MethodsA retrospective review identified 25 patients who had undergone liver transplantation with pre-operative T2*-weighted MRI. All patients had Child's-Pugh A (9), B (9), or C (7) liver disease with 13 transplanted for liver dysfunction and 12 for HCC. The T2*-weighted images were interpreted by 2 blinded, independent observers and the results compared with the explanted specimens. Sensitivity and specificity of T2*-weighted MRI for the identification of HCC was assessed.ResultsBy pathology, 16 HCC (mean largest diameter 2.1 cm; range 0.9-3.6 cm) were identified in 14 patients. Reader 1 had a sensitivity of 69% (95% confidence interval 41-88%) and a specificity of 100% (68-100%). Reader 2 had a sensitivity of 56% (31-79%) and a specificity of 100% (68-100%). There was a very good inter-observer agreement (kappa=0.84).ConclusionT2*-weighted MRI had a moderate sensitivity for identifying HCC but had an excellent specificity. A T2*-weighted MR sequence may be a useful component of a liver MRI protocol due to its high specificity for HCC, and may be particularly useful in patients unable to undergo gadolinium enhanced MRI.Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

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