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European Radiology
Published in: European Radiology 6/2012

01-06-2012 | Gastrointestinal

Assessment of arterial hypervascularity of hepatocellular carcinoma: comparison of contrast-enhanced US and gadoxetate disodium-enhanced MR imaging

Authors: Katsutoshi Sugimoto, Fuminori Moriyasu, Junji Shiraishi, Kazuhiro Saito, Junichi Taira, Toru Saguchi, Yasuharu Imai

Published in: European Radiology | Issue 6/2012

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Abstract

Objective

To compare contrast-enhanced (CE) ultrasound with gadoxetate disodium-enhanced magnetic resonance (MR) imaging in the assessment of arterial hypervascularity of hepatocellular carcinoma (HCC) and dysplastic nodule (DN), with CT during hepatic arteriography (CTHA) as the reference standard.

Methods

This study included 54 consecutively diagnosed patients, with 57 histologically confirmed HCCs and 3 DNs (high-grade). All patients underwent CE ultrasound, gadoxetate disodium-enhanced MR imaging and CTHA. Two trained diagnostic radiologists interpreted the CTHA images and rated the degree of intratumoral arterial vascularity by consensus using a five-point confidence scale as the reference standard. In the observer study, the degrees of vascularity on CE ultrasound and gadoxetate disodium-enhanced MR images were qualitatively analysed by four independent readers using a five-point confidence scale. Diagnostic accuracy was analysed by receiver-operating characteristic (ROC) analysis.

Results

The diagnostic accuracies of the average area under the ROC curve (AUC) were significantly greater with CE ultrasound (average AUC: 0.94; 95% confidence interval [CI]: 0.88–1.00) than with gadoxetate disodium-enhanced MR imaging (average AUC 0.84, 95% CI 0.74–0.93, P = 0.0014).

Conclusion

Contrast-enhanced ultrasound yields a significantly higher AUC value than gadoxetate disodium-enhanced MR imaging in the assessment of arterial hypervascularity of HCC and DN.
Key Points
• Arterial hypervascularity is an important feature determining treatment options in hepatocellular carcinoma.
• It can be assessed by contrast-enhanced (CE) ultrasound or magnetic resonance (MR) imaging.
• CE ultrasound was more accurate than Gd-EOB-DTPA MRI in assessing intratumoral vascularity.
• Hypovascular hepatic nodules should be further investigated using CE ultrasound.
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Metadata
Title
Assessment of arterial hypervascularity of hepatocellular carcinoma: comparison of contrast-enhanced US and gadoxetate disodium-enhanced MR imaging
Authors
Katsutoshi Sugimoto
Fuminori Moriyasu
Junji Shiraishi
Kazuhiro Saito
Junichi Taira
Toru Saguchi
Yasuharu Imai
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
European Radiology / Issue 6/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2372-3

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