• Marion Roux, Frederic Pigneur, Julien Calderaro, Laurence Baranes, Mélanie Chiaradia, Lambros Tselikas, Thomas Decaens, Charlotte Costentin, Alexis Laurent, Daniel Azoulay, Ariane Mallat, Elie-Serge Zafrani, Alain Rahmouni, and Alain Luciani.
• AP-HP, Groupe Henri Mondor Albert Chenevier, Radiology Department, Creteil, France.
• J Magn Reson Imaging. 2015 Nov 1; 42 (5): 1249-58.

PurposeTo determine the value of quantitative analysis of the hepatobiliary phase (HBP) in gadobenate dimeglumine (Gd-BOPTA)-enhanced magnetic resonance imaging (MRI) to differentiate focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA).Materials And MethodsThirty-eight patients bearing 67 lesions (40 FNH; 27 HCA) were retrospectively included in this Institutional Review Board-approved study. The same volumetric interpolated breath-hold examination (VIBE) T1 -weighted sequences were performed before and after contrast injection on a 1.5T MRI, with HBP images acquired with a mean delay of 80 minutes (range 60-120 min). After a visual assessment of lesions enhancement (qualitative HBP analysis), the HBP signal intensity ratio (SIR) and the lesion-to-liver contrast enhancement ratio (LLCER) were calculated for each lesion by two observers (Mann-Whitney test). The sensitivities, specificities (receiver operating characteristic [ROC] curve analysis) and interobserver correlation (intraclass coefficient, ICC) of quantitative HBP analysis were determined.ResultsAll FNH and 44.4% of HCA appeared hyper- or isointense relative to the adjacent liver on qualitative HBP analysis. The mean SIR (P < 0.01) and LLCER (P < 0.0001) of FNH were significantly higher than that of HCA. The area under the ROC curve for the differentiation of FNH from HCA with LLCER was 0.98 for both observers. With a cutoff value of -0.3%-observer 1 with highest experience- LLCER assessment provided respective sensitivity and specificity values of 100% and 96.2% for the differentiation of FNH from HCA. The ICC was 0.7 for SIR measurements and 0.8 for LLCER measurements.ConclusionQuantitative LLCER assessment allows an accurate differentiation of FNH from HCA, even in hyper- or isointense HCA on HBP images.© 2015 Wiley Periodicals, Inc.

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