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- Title
Combined SPIO-gadolinium magnetic resonance imaging in cirrhotic patients: negative predictive value and role in screening for hepatocellular carcinoma.
- Authors
Guiu, Boris; Loffroy, Romaric; Ben Salem, Douraied; Lepage, Come; Guiu, Séverine; Aho, Serge; Jouve, Jean-Louis; Krausé, Denis; Cercueil, Jean-Pierre; Guiu, Séverine; Krausé, Denis
- Abstract
<bold>Background: </bold>The objective of our study was to assess the negative predictive value (NPV) of double-contrast MRI (DC-MRI) with SPIO and gadolinium, and to determine the role of DC-MRI in screening for hepatocellular carcinoma (HCC) in cirrhotic patients.<bold>Methods: </bold>We retrospectively included 160 DC-MRI scans done as second-line investigations in 119 patients with cirrhosis over a 25-month period. Two radiologists independently classified the MRI scans as strongly suggesting HCC (HCC Group), showing benign nodules (benign nodules Group), showing no nodules (no-nodules Group) or indeterminate; they assigned a diagnostic confidence score (DCS) using a 0-10 scale. The reference standard was histology or results of follow-up investigations. Mean follow-up was 16.9 months (12-28 months).<bold>Results: </bold>The radiologists disagreed for two scans (kappa = 0.98). Of 112 scans [benign nodules Group (n = 32) and no-nodules Group (n = 80)], 11 were excluded (3 patients lost to follow-up and 8 who died with no known cancer) while a HCC was detected during follow-up in 8 patients, yielding a NPV of 92% (93/101) (95% confidence interval, 85%-97%). The DCS was in the 4-6 range (indicating uncertainty) for only 6 (3.75%) scans.<bold>Conclusions: </bold>DC-MRI is reliable and reproducible. Its high NPV suggests a role as a second-line investigation after ultrasonography, for HCC screening.
- Subjects
MAGNETIC resonance imaging; GADOLINIUM; CIRRHOSIS of the liver; LIVER cancer; MEDICAL radiology
- Publication
Abdominal Imaging, 2008, Vol 33, Issue 5, p520
- ISSN
0942-8925
- Publication type
journal article
- DOI
10.1007/s00261-007-9327-9