01-09-2015 | Hepatobiliary-Pancreas
Subcentimeter hypervascular nodule with typical imaging findings of hepatocellular carcinoma in patients with history of hepatocellular carcinoma: natural course on serial gadoxetic acid-enhanced MRI and diffusion-weighted imaging
Published in: European Radiology | Issue 9/2015
Login to get accessAbstract
Objectives
To evaluate the natural course of subcentimeter hypervascular nodules at high risk for developing into hepatocellular carcinomas (SHNHR) using serial magnetic resonance imaging (MRI) in patients with a history of hepatocellular carcinoma (HCC).
Methods
An SHNHR was defined as a subcentimeter hypervascular nodule having typical imaging findings of HCC on gadoxetic acid-enhanced MRI and diffusion-weighted imaging. We included 39 patients with 46 SHNHRs (mean size ± standard deviation, 6.1 ± 1.6 mm; range, 3.2 – 9.0 mm). Overt HCC was defined as pathology proven HCC or a nodule larger than 1 cm with typical imaging findings of HCC. The cumulative rate and the independent predictive factors for progression to overt HCC were evaluated.
Results
The median follow-up period was 139 days (range, 64 – 392 days). The cumulative progression rate to overt HCC at 3, 6, 9, and 12 months was 13.9 %, 61.7 %, 83.2 %, and 89.9 %. The initial size of SHNHR was a significant predictor of progression to overt HCC, with an optimal cut-off value of 5.5 mm.
Conclusion
The progression rate of SHNHR to overt HCC within 12 months was high (89.9 %) in patients with history of HCC. The initial size of SHNHR was an important predictor for progression to overt HCC.
Key Points
• Most SHNHRs (89.9 %) progressed to overt HCCs within 12 months.
• Initial size was an important predictor for progression to overt HCCs.
• The optimal cut-off value for initial nodule size was 5.5 mm.