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- Title
Capsule, septum, and T2 hyperintense foci for differentiation between large hepatocellular carcinoma (≥5 cm) and intrahepatic cholangiocarcinoma on gadoxetic acid MRI.
- Authors
Hwang, Jiyoung; Kim, Young; Min, Ji; Choi, Seo-Youn; Jeong, Woo; Hong, Seong; Kim, Hyun-joo; Ahn, Soohyun; Ahn, Hyeon; Kim, Young Kon; Min, Ji Hye; Jeong, Woo Kyung; Hong, Seong Sook; Ahn, Hyeon Seon
- Abstract
<bold>Objective: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusion: </bold>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.<bold>Key Points: </bold>• 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.
- Subjects
LIVER cancer; CHOLANGIOCARCINOMA; MAGNETIC resonance imaging; SEPTUM (Brain); DIAGNOSTIC imaging; BILE ducts; HEPATOCELLULAR carcinoma; LIVER; LIVER tumors; TUMOR classification; CONTRAST media; RETROSPECTIVE studies
- Publication
European Radiology, 2017, Vol 27, Issue 11, p4581
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-017-4846-4