Differentiating hepatocellular carcinoma from dysplastic nodules at gadobenate dimeglumine-enhanced hepatobiliary-phase magnetic resonance imaging

• Published in: Abdominal imaging 2013-08, Vol.38 (4), p.736-744
• Main Authors: Gatto, A., De Gaetano, A. M., Giuga, M., Ciresa, M., Siciliani, L., Miele, L., Riccardi, L., Pizzolante, F., Rapaccini, G. L., Gasbarrini, A., Giuliante, F., Vecchio, F. M., Pompili, M., Bonomo, L.
• Format: Article
• Language: English
• Subjects: Aged; Biopsy, Large-Core Needle; Carcinoma, Hepatocellular - diagnosis; Carcinoma, Hepatocellular - pathology; Contrast Media; Diagnosis, Differential; Female; Gastroenterology; Hepatology; Humans; Image Enhancement; Imaging; Liver Cirrhosis - diagnosis; Liver Cirrhosis - pathology; Liver Neoplasms - diagnosis; Liver Neoplasms - pathology; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Meglumine - analogs & derivatives; Middle Aged; Organometallic Compounds; Radiology
• ISSN: 0942-8925; 2366-004X; 1432-0509; 2366-0058
• DOI: 10.1007/s00261-012-9950-y

Purpose We evaluated whether the addition of delayed phase imaging (DPI) gadobenate dimeglumine-enhanced MRI to dynamic postcontrast imaging improves the characterization of small hepatocellular carcinoma (HCC) and the differentiation between HCC, high grade dysplastic nodules (HGDN), and low grade dysplastic nodules (LGDN). Methods Twenty-five cirrhotic patients with 30 nodules (16 HCC, 8 HGDNs, and 6 LGDNs; maximum size of 3 cm) were included in this retrospective study. The diagnostic reference standard was histology. All the patients underwent MRI both prior to and following intravenous administration of gadobenate dimeglumine. The lesions were classified as hypointense, isointense, hyperintense on DPI for qualitative assessment. In the quantitative analysis the relative tumor-liver contrast to noise ratio (CNR) of the lesions on DPI was calculated. Results All HCCs were hypointense on DPI while only 8 (57.1%) of 14 DNs were hypointense and only 1 of 6 (16.6%) LGDNs was hypointense. There was a statistically significant difference in the hypointensity on DPI between HCCs and DNs ( p  = 0.003) in the qualitative analysis but not in the CNR values while there was a strong statistically significant difference in the hypointensity on DPI in the qualitative ( p  = 0.00001) and quantitative analysis ( p