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European Radiology
Published in: European Radiology 4/2020

01-04-2020 | Magnetic Resonance Imaging | Gastrointestinal

Abbreviated MRI with optional multiphasic CT as an alternative to full-sequence MRI: LI-RADS validation in a HCC-screening cohort

Authors: So Hyun Park, Bohyun Kim, So Yeon Kim, Young Sup Shim, Ju Hyun Kim, Jimi Huh, Hye Jin Kim, Kyung Won Kim, Seung Soo Lee

Published in: European Radiology | Issue 4/2020

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Abstract

Objective

To compare the diagnostic performance of abbreviated MRI (AMRI) combined with multiphasic CT (mCT) with that of full-sequence gadoxetic acid-enhanced MRI (EOB-MRI) in a hepatocellular carcinoma (HCC)-screening cohort

Methods

Consecutive patients at risk of HCC who underwent EOB-MRI and mCT within 3 months for evaluation of new 0.5–3-cm hepatic observations were retrospectively recruited from 3 centers. An AMRI protocol comprising hepatobiliary phase, T2- and diffusion-weighted imaging, and dual-echo sequence was reconstituted from EOB-MRI. Two radiologists independently reviewed each observation in AMRI plus mCT (set 1) and EOB-MRI (set 2) per LI-RADS v2018. Per-lesion sensitivity, accuracy, and positive predictive value (PPV) for HCC were calculated and compared between image sets.

Results

In 267 patients, 306 histologically confirmed observations (280 HCCs, 20 combined hepatocellular-cholangiocarcinomas, 1 cholangiocarcinoma, and 5 benignities) were assessed. Set 1 yielded higher sensitivity (96.4% vs. 92.9%, p = 0.013) and comparable accuracy (91.2% vs. 87.6%) and PPV (94.1% vs. 93.5%) to set 2 using LI-RADS category (LR)-4/5 criteria. The sets showed comparable sensitivity (66.4% vs. 70.4%), accuracy (67.7% vs. 70.6%), and PPV (97.4% vs. 96.6%) using LR-5 criteria. A similar substantial number of non-HCC malignancies were categorized as LR-4 or LR-5, as was the number of HCCs categorized as LR-M in both sets.

Conclusions

AMRI combined with mCT showed diagnostic performance similar or superior to that of EOB-MRI for HCC diagnosis using LI-RADS. Therefore, mCT holds potential as a sequential examination for HCC diagnosis in AMRI-detected hepatic observation in patients at risk of HCC.

Key Points

• AMRI plus multiphasic CT showed comparable accuracy (91.2%) and PPV (94.1%) to full-sequence gadoxetic acid-enhanced MRI using LR-4/5 criteria.
• AMRI plus multiphasic CT was significantly more sensitive than full-sequence gadoxetic acid-enhanced MRI (96.4% vs. 92.9%) using LR-4/5 criteria.
• Multiphasic CT is a potential sequential modality for HCC diagnosis after AMRI.
Appendix
Available only for authorised users
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Metadata
Title
Abbreviated MRI with optional multiphasic CT as an alternative to full-sequence MRI: LI-RADS validation in a HCC-screening cohort
Authors
So Hyun Park
Bohyun Kim
So Yeon Kim
Young Sup Shim
Ju Hyun Kim
Jimi Huh
Hye Jin Kim
Kyung Won Kim
Seung Soo Lee
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06546-5

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