Management of subcentimetre arterially enhancing and hepatobiliary hypointense lesions on gadoxetic acid-enhanced MRI in patients at risk for HCC.
Eur Radiol
; 28(4): 1476-1484, 2018 Apr.
Article
em En
| MEDLINE
| ID: mdl-29063251
ABSTRACT
OBJECTIVES:
To investigate the significance of subcentimetre (≤1 cm) arterially enhancing and hepatobiliary hypointense lesions (SAELs) observed on gadoxetic acid-enhanced magnetic resonance imaging (MRI) of patients at risk of hepatocellular carcinoma (HCC).METHODS:
A SAEL was defined as a subcentimetre hypervascular nodule exhibiting a hepatobiliary phase defect on gadoxetic acid-enhanced MRI. We included 52 SAELs from 46 patients in a HCC surveillance population. The HCC reference standard was pathologic confirmation or a nodule >1 cm with typical imaging features of HCC at follow-up imaging. The malignancy rate and HCC-favourable imaging findings of SAELs were evaluated.RESULTS:
The malignancy rate among SAELs was 57.7% (30/52). At diagnosis, all SAELs that progressed to overt HCC were treatable with curative intention. Venous or late dynamic phase washout was more frequently observed with malignant SAELs than with benign SAELs (57.7% vs. 30.6%; P = 0.01). If SAELs exhibiting washout were considered as HCC, sensitivity, specificity, and positive predictive value was 83.3%, 50%, and 69.4%, respectively.CONCLUSION:
Among patients at risk of HCC, SAELs on gadoxetic acid-enhanced MRI exhibited high malignant potential. However, close observation may be an appropriate strategy for isolated SAELs. A washout appearance may be helpful for predicting malignancy. KEY POINTS ⢠Gadoxetic acid-enhanced MRI provides hepatobiliary phase (HBP) images. ⢠Screening frequently detects subcentimetre arterially enhancing and hepatobiliary hypointense lesions (SAELs). ⢠A majority of SAELs progressed to overt HCC within 2 years. ⢠A venous-phase washout appearance correlated significantly with malignancy in SAELs.Palavras-chave
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Carcinoma Hepatocelular
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Gadolínio DTPA
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Fígado
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Neoplasias Hepáticas
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Coréia do Sul