Published in:
01-01-2015 | Original Article—Liver, Pancreas, and Biliary Tract
Diagnostic accuracy for macroscopic classification of nodular hepatocellular carcinoma: comparison of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging and angiography-assisted computed tomography
Published in: Journal of Gastroenterology | Issue 1/2015
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Background
The macroscopic type of hepatocellular carcinoma (HCC) is a predictor of prognosis. We clarified the diagnostic value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)–enhanced magnetic resonance imaging (MRI) in the macroscopic classification of nodular hepatocellular carcinoma (HCC) as compared to angiography-assisted computed tomography (CT).
Methods
A total of 71 surgically resected nodular HCCs with a maximum diameter of ≤5 cm were investigated. HCCs were evaluated preoperatively using Gd-EOB-DTPA–enhanced MRI and angiography-assisted CT. HCCs were pathologically classified as simple nodular (SN), SN with extranodular growth (SN-EG), or confluent multinodular (CMN). SN-EG and CMN were grouped as non-SN. Five readers independently reviewed the images using a five-point scale. We examined the accuracy of both imaging modalities in differentiating between SN and non-SN HCC.
Results
Overall, the area under the receiver operating characteristic curve (A
z
) for the diagnosis of non-SN did not differ between Gd-EOB-DTPA–enhanced MRI and angiography-assisted CT [0.879 (95 % confidence interval (CI), 0.779–0.937) and 0.845 (95 % CI, 0.723–0.919), respectively]. For HCCs >2 cm, the A
z
for Gd-EOB-DTPA–enhanced MRI was greater than 0.9. The sensitivity, specificity, and accuracy of Gd-EOB-DTPA–enhanced MRI for identifying non-SN were equal to or higher than values with angiography-assisted CT in all three categories (all tumors, ≤2 cm, and >2 cm), but the differences were not statistically significant.
Conclusions
Using Gd-EOB-DTPA–enhanced MRI to assess the macroscopic findings in nodular HCC was equal or superior to using angiography-assisted CT.