Noncontrast MRI with diffusion-weighted imaging as the sole imaging modality for detecting liver malignancy in patients with high risk for hepatocellular carcinoma
- Authors
- Kim, Y.K.; Kim, Y.K.; Park, H.J.; Park, M.J.; Lee, W.J.; Choi, D.
- Issue Date
- Jul-2014
- Publisher
- Elsevier Inc.
- Keywords
- Cholangiocarcinoma; Diffusion-weighted imaging; Gd-EOB-DTPA; Hepatocellular carcinoma; Noncontrast magnetic resonance imaging
- Citation
- Magnetic Resonance Imaging, v.32, no.6, pp 610 - 618
- Pages
- 9
- Journal Title
- Magnetic Resonance Imaging
- Volume
- 32
- Number
- 6
- Start Page
- 610
- End Page
- 618
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/13818
- DOI
- 10.1016/j.mri.2013.12.021
- ISSN
- 0730-725X
1873-5894
- Abstract
- Purpose: To compare the diagnostic performance of the noncontrast MRI including DWI to the standard MRI for detecting hepatic malignancies in patients with chronic liver disease. Materials and methods: We included 135 patients with 136 histologically-confirmed hepatocellular carcinomas (HCCs), 12 cholangiocarcinomas, and 34 benign lesions (≤ 2.0 cm), and 22 patients with cirrhosis but no focal liver lesion who underwent 3.0 T liver MRI. Noncontrast MRI set (T1- and T2-weighted images and DWI) and standard MRI set (gadoxetic acid-enhanced and noncontrast MRI) were analyzed independently by three observers to detect liver malignancies using receiver operating characteristic analysis. Results: The Az value of the noncontrast MRI (mean, 0.906) was not inferior to that of the combined MRI (mean, 0.924) for detecting malignancies by all observers (P> 0.05). For each observer, no significant difference was found in the sensitivity and specificity between the two MRI sets for detecting liver malignancies and distinguishing them from benign lesions (P> 0.05), whereas negative predictive value was higher with the combined MRI than with the noncontrast MRI (P= 0.0001). When using pooled data, the sensitivity of the combined MRI (mean 94.8%) was higher than that of the noncontrast MRI (mean, 91.7%) (P = 0.001), whereas specificity was equivalent (78.6% vs 77.5%). Conclusion: Noncontrast MRI including DWI showed reasonable performance compared to the combined gadoxetic acid-enhanced and noncontrast MRI set for detecting HCC and cholangiocarcinoma and differentiating them from benign lesions in patients with chronic liver disease. © 2014 Elsevier Inc.
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