Diagnostic accuracy of MRI with extracellular vs. hepatobiliary contrast material for detection of residual hepatocellular carcinoma after locoregional treatment

Jordi Rimola, Matthew S. Davenport, Peter S. Liu, Theodore Brown, Jorge A. Marrero, Barbara J. McKenna, Hero K. Hussain

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: To compare the diagnostic accuracy of extracellular gadolinium-based contrast-enhanced MRI (Gd-MRI) and gadoxetic acid-enhanced MRI (EOB-MRI) for the assessment of hepatocellular carcinoma (HCC) response to locoregional therapy (LRT) using explant correlation as the reference standard. Methods: Forty-nine subjects with cirrhosis and HCC treated with LRT who underwent liver MRI using either Gd-MRI (n = 26) or EOB-MRI (n = 23) within 90 days of liver transplantation were included. Four radiologists reviewed the MR images blinded to histology to determine the size and percentage of viable residual HCC using a per-lesion explant reference standard. Sensitivities, specificities, accuracies, and agreement with histology for the detection residual HCC were calculated. Results: Gd-MRI had greater agreement with histology (ICC: 0.98 [0.95–0.99] vs. 0.80 [0.63–0.90]) and greater sensitivity for viable HCC (76% [13/17 50–93%] vs. 58% [7/12; 28–85%]) than EOB-MRI; specificities were similar (84% [16/19; 60–97%] vs. 85% [23/27; 66–96%]). Areas under ROC curves for detecting residual viable tumor were 0.80 (0.64–0.92) for Gd-MRI and 0.72 (0.55–0.85) for EOB-MRI. Gd-MRI had greater inter-rater agreement than EOB-MRI for determining the size of residual viable HCC (ICC: 0.96 [0.92–0.98] vs. 0.85 [0.72–0.92]). Conclusion: Gd-MRI may be more accurate and precise than EOB-MRI for the assessment of viable HCC following LRT.

Original languageEnglish (US)
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Gadolinium
Contrast Media
Hepatocellular Carcinoma
Histology
Therapeutics
Residual Neoplasm
ROC Curve
Liver Transplantation
Area Under Curve
Fibrosis
Sensitivity and Specificity
Liver

Keywords

  • Hepatocellular carcinoma
  • Liver
  • Magnetic resonance imaging
  • Radiofrequency ablation
  • Trans-arterial chemoembolization

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

Diagnostic accuracy of MRI with extracellular vs. hepatobiliary contrast material for detection of residual hepatocellular carcinoma after locoregional treatment. / Rimola, Jordi; Davenport, Matthew S.; Liu, Peter S.; Brown, Theodore; Marrero, Jorge A.; McKenna, Barbara J.; Hussain, Hero K.

In: Abdominal Radiology, 01.01.2018.

Research output: Contribution to journalArticle

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abstract = "Purpose: To compare the diagnostic accuracy of extracellular gadolinium-based contrast-enhanced MRI (Gd-MRI) and gadoxetic acid-enhanced MRI (EOB-MRI) for the assessment of hepatocellular carcinoma (HCC) response to locoregional therapy (LRT) using explant correlation as the reference standard. Methods: Forty-nine subjects with cirrhosis and HCC treated with LRT who underwent liver MRI using either Gd-MRI (n = 26) or EOB-MRI (n = 23) within 90 days of liver transplantation were included. Four radiologists reviewed the MR images blinded to histology to determine the size and percentage of viable residual HCC using a per-lesion explant reference standard. Sensitivities, specificities, accuracies, and agreement with histology for the detection residual HCC were calculated. Results: Gd-MRI had greater agreement with histology (ICC: 0.98 [0.95–0.99] vs. 0.80 [0.63–0.90]) and greater sensitivity for viable HCC (76{\%} [13/17 50–93{\%}] vs. 58{\%} [7/12; 28–85{\%}]) than EOB-MRI; specificities were similar (84{\%} [16/19; 60–97{\%}] vs. 85{\%} [23/27; 66–96{\%}]). Areas under ROC curves for detecting residual viable tumor were 0.80 (0.64–0.92) for Gd-MRI and 0.72 (0.55–0.85) for EOB-MRI. Gd-MRI had greater inter-rater agreement than EOB-MRI for determining the size of residual viable HCC (ICC: 0.96 [0.92–0.98] vs. 0.85 [0.72–0.92]). Conclusion: Gd-MRI may be more accurate and precise than EOB-MRI for the assessment of viable HCC following LRT.",
keywords = "Hepatocellular carcinoma, Liver, Magnetic resonance imaging, Radiofrequency ablation, Trans-arterial chemoembolization",
author = "Jordi Rimola and Davenport, {Matthew S.} and Liu, {Peter S.} and Theodore Brown and Marrero, {Jorge A.} and McKenna, {Barbara J.} and Hussain, {Hero K.}",
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T1 - Diagnostic accuracy of MRI with extracellular vs. hepatobiliary contrast material for detection of residual hepatocellular carcinoma after locoregional treatment

AU - Rimola, Jordi

AU - Davenport, Matthew S.

AU - Liu, Peter S.

AU - Brown, Theodore

AU - Marrero, Jorge A.

AU - McKenna, Barbara J.

AU - Hussain, Hero K.

PY - 2018/1/1

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N2 - Purpose: To compare the diagnostic accuracy of extracellular gadolinium-based contrast-enhanced MRI (Gd-MRI) and gadoxetic acid-enhanced MRI (EOB-MRI) for the assessment of hepatocellular carcinoma (HCC) response to locoregional therapy (LRT) using explant correlation as the reference standard. Methods: Forty-nine subjects with cirrhosis and HCC treated with LRT who underwent liver MRI using either Gd-MRI (n = 26) or EOB-MRI (n = 23) within 90 days of liver transplantation were included. Four radiologists reviewed the MR images blinded to histology to determine the size and percentage of viable residual HCC using a per-lesion explant reference standard. Sensitivities, specificities, accuracies, and agreement with histology for the detection residual HCC were calculated. Results: Gd-MRI had greater agreement with histology (ICC: 0.98 [0.95–0.99] vs. 0.80 [0.63–0.90]) and greater sensitivity for viable HCC (76% [13/17 50–93%] vs. 58% [7/12; 28–85%]) than EOB-MRI; specificities were similar (84% [16/19; 60–97%] vs. 85% [23/27; 66–96%]). Areas under ROC curves for detecting residual viable tumor were 0.80 (0.64–0.92) for Gd-MRI and 0.72 (0.55–0.85) for EOB-MRI. Gd-MRI had greater inter-rater agreement than EOB-MRI for determining the size of residual viable HCC (ICC: 0.96 [0.92–0.98] vs. 0.85 [0.72–0.92]). Conclusion: Gd-MRI may be more accurate and precise than EOB-MRI for the assessment of viable HCC following LRT.

AB - Purpose: To compare the diagnostic accuracy of extracellular gadolinium-based contrast-enhanced MRI (Gd-MRI) and gadoxetic acid-enhanced MRI (EOB-MRI) for the assessment of hepatocellular carcinoma (HCC) response to locoregional therapy (LRT) using explant correlation as the reference standard. Methods: Forty-nine subjects with cirrhosis and HCC treated with LRT who underwent liver MRI using either Gd-MRI (n = 26) or EOB-MRI (n = 23) within 90 days of liver transplantation were included. Four radiologists reviewed the MR images blinded to histology to determine the size and percentage of viable residual HCC using a per-lesion explant reference standard. Sensitivities, specificities, accuracies, and agreement with histology for the detection residual HCC were calculated. Results: Gd-MRI had greater agreement with histology (ICC: 0.98 [0.95–0.99] vs. 0.80 [0.63–0.90]) and greater sensitivity for viable HCC (76% [13/17 50–93%] vs. 58% [7/12; 28–85%]) than EOB-MRI; specificities were similar (84% [16/19; 60–97%] vs. 85% [23/27; 66–96%]). Areas under ROC curves for detecting residual viable tumor were 0.80 (0.64–0.92) for Gd-MRI and 0.72 (0.55–0.85) for EOB-MRI. Gd-MRI had greater inter-rater agreement than EOB-MRI for determining the size of residual viable HCC (ICC: 0.96 [0.92–0.98] vs. 0.85 [0.72–0.92]). Conclusion: Gd-MRI may be more accurate and precise than EOB-MRI for the assessment of viable HCC following LRT.

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KW - Liver

KW - Magnetic resonance imaging

KW - Radiofrequency ablation

KW - Trans-arterial chemoembolization

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