Targetoid hepatic observations on gadoxetic acid-enhanced MRI using LI-RADS version 2018: emphasis on hepatocellular carcinomas assigned to the LR-M category
- Authors
- Park, HJ[Park, H. J.]; Kim, YK[Kim, Y. K.]; Cha, DI[Cha, D., I]; Ko, SE[Ko, S. E.]; Kim, S[Kim, S.]; Lee, ES[Lee, E. S.]; Ahn, S[Ahn, S.]
- Issue Date
- Jun-2020
- Publisher
- W B SAUNDERS CO LTD
- Citation
- CLINICAL RADIOLOGY, v.75, no.6, pp.478.e13 - 478.e23
- Indexed
- SCIE
SCOPUS
- Journal Title
- CLINICAL RADIOLOGY
- Volume
- 75
- Number
- 6
- Start Page
- 478.e13
- End Page
- 478.e23
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/4408
- DOI
- 10.1016/j.crad.2020.01.002
- ISSN
- 0009-9260
- Abstract
- AIM: To determine useful imaging features for differentiating hepatocellular carcinoma (HCC) categorised as LR-M from non-HCC malignancies in using the Liver Imaging-Reporting and Data System (LI-RADS) version 2018 on gadoxetic acid-enhanced magnetic resonance imaging (MRI). MATERIALS AND METHODS: Patients at high-risk for HCC with surgically confirmed HCCs (n=131) and non-HCC malignancies (n=90) and who had undergone gadoxetic acid-enhanced MRI were included. LI-RADS categories were assigned to identify hepatic observations defined as LR-M by two radiologists. Major and ancillary imaging features of hepatic observation with targetoid appearance including intratumoural septa were compared between HCCs and non-HCC malignancies. A classification tree analysis (CTA) was applied to differentiate high-risk HCCs from non-HCC malignancies in the LR-M category. RESULTS: A total of 36 HCCs (27.5%) and 70 non-HCC malignancies (77.8%) were assigned as LR-M. An enhancing capsule (p=0.0293), blood products in the mass (p=0.0393), non-targetoid restriction (p=0.018), and a septum (p=0.0053) were significantly predictive of HCC. On CTA, the presence of a septum was an initial predictor for a high probability of HCC followed by non-targetoid restriction. The CTA model has a sensitivity of 63.9%, specificity of 90%, and accuracy of 81.1% for differentiating HCC assigned LR-M from non-HCC malignancy. CONCLUSION: A considerable proportion of HCCs could have been categorised as LR-M as they had a targetoid appearance on gadoxetic acid-enhanced MRI. An intratumoural septum and non-targetoid restriction as well as enhancing capsule and blood products in the mass may be useful for differentiating HCC assigned to LR-M from non-HCC malignancy on gadoxetic acid-enhanced MRI. (C) 2020 Published by Elsevier Ltd on behalf of The Royal College of Radiologists.
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