Abstract
Purpose: To identify the most reliable imaging features for differentiating hepatocellular carcinoma with paradoxical uptake on the hepatobiliary phase (HCCpara) from focal nodular hyperplasia (FNH)-like nodules using Gd-EOB-DTPA-enhanced MRI. Materials and Methods: This was a retrospective study. Twenty patients with HCCpara and 21 patients with FNH-like nodules were included. The following MRI features were evaluated using 3.0 Tesla unit by two radiologists: signal intensity (SI) on T1-, T2-, and diffusion-weighted imaging (DWI), arterial enhancement pattern, washout appearance on the portal venous phase (PVP) and/or transitional phase (TP), uptake pattern on the hepatobiliary phase (HBP), “T2 scar,” “EOB scar,” and chemical shift on in- and out-of-phase images. Multivariate logistic regression analysis was performed to assess MRI features for prediction of HCCpara. Results: Compared with FNH-like nodules, HCCpara had significantly more frequent heterogeneous T1 SI (P < 0.0001), T2 hyperintensity (P = 0.032), heterogeneous arterial enhancement (P < 0.0001), washout appearance on the PVP and/or TP (P < 0.0001), heterogeneous uptake on the HBP (P < 0.0001), absence of “EOB scar” (P < 0.0001), and hyperintensity on DWI (P = 0.004). Multivariate logistic regression analysis revealed washout appearance as the only independent imaging feature associated with HCCpara (odds ratio, 7.019; P = 0.042). Washout appearance also showed the best diagnostic performance with a sensitivity of 90% and a specificity of 100%. Conclusion: Washout appearance on the PVP and/or TP is the most reliable imaging feature for differentiating HCCpara from FNH-like nodules. Level of Evidence: 3. J. MAGN. RESON. IMAGING 2017;45:1599–1608.
| Original language | English |
|---|---|
| Pages (from-to) | 1599-1608 |
| Number of pages | 10 |
| Journal | Journal of Magnetic Resonance Imaging |
| Volume | 45 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2017 Jun 1 |
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Keywords
- FNH like nodule
- gadoxetic acid
- hepatocellular carcinoma
- magnetic resonance imaging
- washout
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Washout appearance in Gd-EOB-DTPA-enhanced MR imaging : A differentiating feature between hepatocellular carcinoma with paradoxical uptake on the hepatobiliary phase and focal nodular hyperplasia-like nodules. / Kim, Jeong Woo; Lee, Chang-Hee; Kim, Soo Byn; Park, Bit Na; Park, Yang Shin; Lee, Jongmee; Park, Cheol Min.
In: Journal of Magnetic Resonance Imaging, Vol. 45, No. 6, 01.06.2017, p. 1599-1608.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Washout appearance in Gd-EOB-DTPA-enhanced MR imaging
T2 - A differentiating feature between hepatocellular carcinoma with paradoxical uptake on the hepatobiliary phase and focal nodular hyperplasia-like nodules
AU - Kim, Jeong Woo
AU - Lee, Chang-Hee
AU - Kim, Soo Byn
AU - Park, Bit Na
AU - Park, Yang Shin
AU - Lee, Jongmee
AU - Park, Cheol Min
PY - 2017/6/1
Y1 - 2017/6/1
N2 - Purpose: To identify the most reliable imaging features for differentiating hepatocellular carcinoma with paradoxical uptake on the hepatobiliary phase (HCCpara) from focal nodular hyperplasia (FNH)-like nodules using Gd-EOB-DTPA-enhanced MRI. Materials and Methods: This was a retrospective study. Twenty patients with HCCpara and 21 patients with FNH-like nodules were included. The following MRI features were evaluated using 3.0 Tesla unit by two radiologists: signal intensity (SI) on T1-, T2-, and diffusion-weighted imaging (DWI), arterial enhancement pattern, washout appearance on the portal venous phase (PVP) and/or transitional phase (TP), uptake pattern on the hepatobiliary phase (HBP), “T2 scar,” “EOB scar,” and chemical shift on in- and out-of-phase images. Multivariate logistic regression analysis was performed to assess MRI features for prediction of HCCpara. Results: Compared with FNH-like nodules, HCCpara had significantly more frequent heterogeneous T1 SI (P < 0.0001), T2 hyperintensity (P = 0.032), heterogeneous arterial enhancement (P < 0.0001), washout appearance on the PVP and/or TP (P < 0.0001), heterogeneous uptake on the HBP (P < 0.0001), absence of “EOB scar” (P < 0.0001), and hyperintensity on DWI (P = 0.004). Multivariate logistic regression analysis revealed washout appearance as the only independent imaging feature associated with HCCpara (odds ratio, 7.019; P = 0.042). Washout appearance also showed the best diagnostic performance with a sensitivity of 90% and a specificity of 100%. Conclusion: Washout appearance on the PVP and/or TP is the most reliable imaging feature for differentiating HCCpara from FNH-like nodules. Level of Evidence: 3. J. MAGN. RESON. IMAGING 2017;45:1599–1608.
AB - Purpose: To identify the most reliable imaging features for differentiating hepatocellular carcinoma with paradoxical uptake on the hepatobiliary phase (HCCpara) from focal nodular hyperplasia (FNH)-like nodules using Gd-EOB-DTPA-enhanced MRI. Materials and Methods: This was a retrospective study. Twenty patients with HCCpara and 21 patients with FNH-like nodules were included. The following MRI features were evaluated using 3.0 Tesla unit by two radiologists: signal intensity (SI) on T1-, T2-, and diffusion-weighted imaging (DWI), arterial enhancement pattern, washout appearance on the portal venous phase (PVP) and/or transitional phase (TP), uptake pattern on the hepatobiliary phase (HBP), “T2 scar,” “EOB scar,” and chemical shift on in- and out-of-phase images. Multivariate logistic regression analysis was performed to assess MRI features for prediction of HCCpara. Results: Compared with FNH-like nodules, HCCpara had significantly more frequent heterogeneous T1 SI (P < 0.0001), T2 hyperintensity (P = 0.032), heterogeneous arterial enhancement (P < 0.0001), washout appearance on the PVP and/or TP (P < 0.0001), heterogeneous uptake on the HBP (P < 0.0001), absence of “EOB scar” (P < 0.0001), and hyperintensity on DWI (P = 0.004). Multivariate logistic regression analysis revealed washout appearance as the only independent imaging feature associated with HCCpara (odds ratio, 7.019; P = 0.042). Washout appearance also showed the best diagnostic performance with a sensitivity of 90% and a specificity of 100%. Conclusion: Washout appearance on the PVP and/or TP is the most reliable imaging feature for differentiating HCCpara from FNH-like nodules. Level of Evidence: 3. J. MAGN. RESON. IMAGING 2017;45:1599–1608.
KW - FNH like nodule
KW - gadoxetic acid
KW - hepatocellular carcinoma
KW - magnetic resonance imaging
KW - washout
UR - http://www.scopus.com/inward/record.url?scp=84991070858&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84991070858&partnerID=8YFLogxK
U2 - 10.1002/jmri.25493
DO - 10.1002/jmri.25493
M3 - Article
C2 - 27726242
AN - SCOPUS:84991070858
VL - 45
SP - 1599
EP - 1608
JO - Journal of Magnetic Resonance Imaging
JF - Journal of Magnetic Resonance Imaging
SN - 1053-1807
IS - 6
ER -