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European Radiology
Published in: European Radiology 11/2017

01-11-2017 | Magnetic Resonance

Capsule, septum, and T2 hyperintense foci for differentiation between large hepatocellular carcinoma (≥5 cm) and intrahepatic cholangiocarcinoma on gadoxetic acid MRI

Authors: Jiyoung Hwang, Young Kon Kim, Ji Hye Min, Seo-Youn Choi, Woo Kyung Jeong, Seong Sook Hong, Hyun-joo Kim, Soohyun Ahn, Hyeon Seon Ahn

Published in: European Radiology | Issue 11/2017

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Abstract

Objective

To determine the added value of capsule, septum, and T2 hyperintense foci for differentiating large hepatocellular carcinoma (HCC; ≥ 5 cm) from intrahepatic cholangiocarcinoma (ICC) using gadoxetic acid MRI.

Methods

The study included 116 patients (94 men, 22 women; mean age, 56.8 years) with surgically confirmed HCCs (n = 87, 5.0–18.0 cm) or ICCs (n = 29, 5.0–14.0 cm) who underwent gadoxetic acid MRI. Three observers independently reviewed MRIs in two sessions, examining enhancement patterns only and then adding capsule, septum, and T2 hyperintense foci. Reviewers used a five-point scale to score accuracy, sensitivity, and specificity.

Results

A significant increase was observed in accuracy when ancillary features (96.1–98.3%) were added compared to enhancement pattern only (83.6–88.4%; p ≤ 0.02). Sensitivity was significantly increased with combined reading (97.1–98.3%) compared to enhancement features only (81.6–88.5%; p ≤ 0.006) for two observers, with no difference in specificity (84.5–89.7% vs. 86.2–98.3%; p > 0.05). We found substantial to excellent interobserver agreement for ancillary features (0.598–0.976).

Conclusion

Adding capsule, septum, and T2 hyperintense foci to enhancement patterns for gadoxetic acid MRI increased diagnostic performance for characterizing large HCC by differentiating it from ICC.

Key Points

• Capsule, septum, and T2 hyperintense foci were useful for characterizing large HCC.
• Adding ancillary features to enhancement pattern increased accuracy for diagnosing large HCC.
• Interobserver agreement was substantial to excellent for ancillary features.
Appendix
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Metadata
Title
Capsule, septum, and T2 hyperintense foci for differentiation between large hepatocellular carcinoma (≥5 cm) and intrahepatic cholangiocarcinoma on gadoxetic acid MRI
Authors
Jiyoung Hwang
Young Kon Kim
Ji Hye Min
Seo-Youn Choi
Woo Kyung Jeong
Seong Sook Hong
Hyun-joo Kim
Soohyun Ahn
Hyeon Seon Ahn
Publication date
01-11-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4846-4

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