Hepatocellular carcinoma detection: diagnostic performance of a simulated abbreviated MRI protocol combining diffusion-weighted and T1-weighted imaging at the delayed phase post gadoxetic acid

Cecilia Besa, Sara Lewis, Pari V. Pandharipande, Jagpreet Chhatwal, Amita Kamath, Nancy Cooper, Ashley Knight-Greenfield, James S. Babb, Paolo Boffetta, Norma Padron, Claude B. Sirlin, Bachir Taouli

Research output: Contribution to journalArticlepeer-review

111 Scopus citations

Abstract

Purpose: The purpose of this study was to evaluate the diagnostic performance of a “simulated” abbreviated MRI (AMRI) protocol using diffusion-weighted imaging (DWI) and T1-weighted (T1w) imaging obtained at the hepatobiliary phase (HBP) post gadoxetic acid injection alone and in combination, compared to dynamic contrast-enhanced (CE)-T1w imaging for the detection of hepatocellular carcinoma (HCC). Methods: This was an IRB approved HIPAA compliant retrospective single institution study including patients with liver disease who underwent gadoxetic acid-enhanced MRI for HCC diagnosis. Three independent observers assessed 2 sets of images (full CE-set and AMRI including DWI+T1w-HBP). Diagnostic performance of T1w-HBP and DWI alone and in combination was compared to that of CE-set. All imaging sets included unenhanced T1w and T2w sequences. A preliminary analysis was performed to assess cost savings of AMRI protocol compared to a full MRI study. Results: 174 patients including 62 with 80 HCCs were assessed. Equivalent per-patient sensitivity and negative predictive value (NPV) were observed for DWI (85.5% and 92.2%, pooled data) and T1w-HBP (89.8% and 94.2%) (P = 0.1–0.7), while these were significantly lower for the full AMRI protocol (DWI+T1w-HBP, 80.6% and 80%, P = 0.02) when compared to CE-set (90.3% and 94.9%). Higher specificity and positive predictive value were observed for CE-set vs. AMRI (P = 0.02). The estimated cost reduction of AMRI versus full MRI ranged between 30.7 and 49.0%. Conclusion: AMRI using DWI and T1w-HBP has a clinically acceptable sensitivity and NPV for HCC detection. This could serve as the basis for a future study assessing AMRI for HCC screening and surveillance.

Original languageEnglish
Pages (from-to)179-190
Number of pages12
JournalAbdominal Radiology
Volume42
Issue number1
DOIs
StatePublished - 1 Jan 2017

Keywords

  • Diffusion-weighted imaging
  • Gadoxetic acid
  • Hepatocellular carcinoma
  • MRI

Fingerprint

Dive into the research topics of 'Hepatocellular carcinoma detection: diagnostic performance of a simulated abbreviated MRI protocol combining diffusion-weighted and T1-weighted imaging at the delayed phase post gadoxetic acid'. Together they form a unique fingerprint.

Cite this