Purpose: To investigate whether the malignancy of atypical nodules in cirrhosis can be identified at gadoxeticacid- disodium(Gd-EOB-DTPA)-MRI by their hypointensity in the hepatobiliary(HB)-phase alone or combined with any other MR imaging features. Materials and Methods: One hundred eleven atypical nodules detected in 77 consecutive Gd-EOB-DTPA-MRIs were divided, based on arterial-phase behavior, into: Class I, isovascular (n ¼ 82), and Class II, hypervascular without portal/delayed washout (n ¼ 29). The two classes were further grouped based on HB-phase intensity (A/B/ C hypo/iso/hyperintensity). Portal/venous/equilibriumphase behavior and T2w features were also collected. Histology was the gold standard. Per-nodule sensitivity, specificity, negative and positive predictive values (NPV/PPV), and diagnostic accuracy were calculated for HB-phase hypointensity alone, and combined with vascular patterns and T2w hyperintensity. Results: Histology detected 60 benign and 51 malignant/ premalignant nodules [10 overt hepatocellular carcinomas (HCCs) and 41 high-grade dysplastic nodules (HGDN)/ early HCC]. Class IA contained 31 (94%) malignancies, IB one (3%), and IC only benign lesions. Class IIA had 100% malignancies, IIB three (37.5%) and IIC only two (28.5%). HB-phase hypointensity alone (Classes I–IIA) had 88% sensitivity, 91% NPV, and 93% diagnostic accuracy, superior (P < 0.05, P < 0.006, and P < 0.05, respectively) to any other MR imaging feature alone or combined. Conclusion: In atypical cirrhotic nodules, HB-phase hypointensity by itself is the strongest marker of malignancy.
Which is the best MRI marker of malignancy for atypical cirrhotic nodules: hypointensity in hepatobiliary phase alone or combined with other features? Classification after Gd-EOB-DTPA administration / Golfieri R; Grazioli L; Orlando E; Dormi A; Lucidi V; Corcioni B; Dettori E; Romanini L; Renzulli M. - In: JOURNAL OF MAGNETIC RESONANCE IMAGING. - ISSN 1053-1807. - STAMPA. - 36(3):(2012), pp. 648-657. [10.1002/jmri.23685]
Which is the best MRI marker of malignancy for atypical cirrhotic nodules: hypointensity in hepatobiliary phase alone or combined with other features? Classification after Gd-EOB-DTPA administration.
Golfieri R;DORMI, ADA;
2012
Abstract
Purpose: To investigate whether the malignancy of atypical nodules in cirrhosis can be identified at gadoxeticacid- disodium(Gd-EOB-DTPA)-MRI by their hypointensity in the hepatobiliary(HB)-phase alone or combined with any other MR imaging features. Materials and Methods: One hundred eleven atypical nodules detected in 77 consecutive Gd-EOB-DTPA-MRIs were divided, based on arterial-phase behavior, into: Class I, isovascular (n ¼ 82), and Class II, hypervascular without portal/delayed washout (n ¼ 29). The two classes were further grouped based on HB-phase intensity (A/B/ C hypo/iso/hyperintensity). Portal/venous/equilibriumphase behavior and T2w features were also collected. Histology was the gold standard. Per-nodule sensitivity, specificity, negative and positive predictive values (NPV/PPV), and diagnostic accuracy were calculated for HB-phase hypointensity alone, and combined with vascular patterns and T2w hyperintensity. Results: Histology detected 60 benign and 51 malignant/ premalignant nodules [10 overt hepatocellular carcinomas (HCCs) and 41 high-grade dysplastic nodules (HGDN)/ early HCC]. Class IA contained 31 (94%) malignancies, IB one (3%), and IC only benign lesions. Class IIA had 100% malignancies, IIB three (37.5%) and IIC only two (28.5%). HB-phase hypointensity alone (Classes I–IIA) had 88% sensitivity, 91% NPV, and 93% diagnostic accuracy, superior (P < 0.05, P < 0.006, and P < 0.05, respectively) to any other MR imaging feature alone or combined. Conclusion: In atypical cirrhotic nodules, HB-phase hypointensity by itself is the strongest marker of malignancy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.