Intra-individual comparison of hepatocellular carcinoma imaging features on contrast-enhanced computed tomography,gadopentetate dimeglumine-enhanced MRI,and gadoxetic acid-enhanced MRI

Abstract

Background

Gadoxetic acid is being widely used for detection and characterization of hepatic nodules. However, there are no data regarding intra-individual comparison of imaging features of hepatocellular carcinoma (HCC) on dynamic computed tomography (CT), gadopentetate dimeglumine-enhanced magnetic resonance imaging (Gd-DTPA-MRI), and gadoxetic acid-enhanced MRI (Gd-EOB-MRI).

Purpose

To evaluate typical imaging features of HCC and capsule appearance with dynamic CT, Gd-DTPA-MRI, and Gd-EOB-MRI.

Material and Methods

We retrospectively reviewed 56 HCCs in 49 patients. Lesion attenuation/signal intensity was graded using a five-point scale based on dynamic phase and hepatobiliary phase (HBP) imaging. Subjective washout and capsule appearance were evaluated on portal venous phase (PVP) or delayed/transitional phase (DP/TP) imaging. The tumor-to-liver contrast ratio (TLCR) was calculated.

Results

Gd-DTPA-MRI and Gd-EOB-MRI was graded higher than CT on arterial phase (P < 0.001). Gd-EOB-MRI was graded lower than Gd-DTPA-MRI on PVP and DP/TP (P < 0.05). The detection rate of subjective washout and capsule appearance did not differ among the three imaging studies on either PVP or DP/TP. TLCR of Gd-EOB-MRI was lower than CT on PVP (P = 0.004) and was lower than Gd-DTPA-MRI on DP/TP (P = 0.001).

Conclusion

Arterial phase hyperenhancement and washout appearance of HCC were well demonstrated in Gd-EOB-MRI. The detection of capsule appearance using Gd-EOB-MRI was not inferior to Gd-DTPA-MRI or CT.

Keywords

Hepatocellular carcinoma magnetic resonance imaging (MRI)gadoxetic acid gadopentetate dimeglumine computed tomography (CT)

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