• Acta radiologica · Oct 2012

    Comparative Study

    Detection of hepatocellular carcinoma in gadoxetic acid-enhanced MRI and diffusion-weighted MRI with respect to the severity of liver cirrhosis.

    • Ah Yeong Kim, Young Kon Kim, Min Woo Lee, Min Jung Park, Jiyoung Hwang, Mi Hee Lee, and Jae Won Lee.
    • Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
    • Acta Radiol. 2012 Oct 1; 53 (8): 830-8.

    BackgroundAs gadoxetic acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) have been widely used for the evaluation of hepatocellular carcinoma (HCC), it is clinically relevant to determine the diagnostic efficacy of gadoxetic acid-enhanced MRI and DWI for detection of HCCs with respect to the severity of liver cirrhosis.PurposeTo compare the diagnostic accuracy and sensitivity of gadoxetic acid-enhanced MRI and DWI for detection of HCCs with respect to the severity of liver cirrhosis.Material And MethodsA total of 189 patients with 240 HCCs (≤3.0 cm) (Child-Pugh A, 81 patients with 90 HCCs; Child-Pugh B, 65 patients with 85 HCCs; Child-Pugh C, 43 patients with 65 HCCs) underwent DWI and gadoxetic acid-enhanced MRI at 3.0 T. A gadoxetic acid set (dynamic and hepatobiliary phase plus T2-weighted image) and DWI set (DWI plus unenhanced MRIs) for each Child-Pugh class were analyzed independently by two observers for detecting HCCs using receiver-operating characteristic analysis. The diagnostic accuracy and sensitivity were calculated.ResultsThere was a trend toward decreased diagnostic accuracy for gadoxetic acid and DWI set with respect to the severity of cirrhosis (Child-Pugh A [mean 0.974, 0.961], B [mean 0.904, 0.863], C [mean 0.779, 0.760]). For both observers, the sensitivities of both image sets were highest in Child-Pugh class A (mean 95.6%, 93.9%), followed by class B (mean 83.0%, 77.1%), and class C (mean 60.6%, 60.0%) (P < 0.05).ConclusionIn HCC detection, the diagnostic accuracy and sensitivity for gadoxetic acid-enhanced MRI and DWI were highest in Child-Pugh class A, followed by Child-Pugh class B, and Child-Pugh class C, indicating a tendency toward decreased diagnostic capability with the severity of cirrhosis.

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