Added value of Gd-EOB-DTPA-enhanced Hepatobiliary phase MR imaging in evaluation of focal solid hepatic lesions

BMC Medical Imaging

Philipp Wiggermann¹  Christian Stroszczynski¹  Andreas Georg Schreyer¹  Patrick Hoffstetter¹  Christoph Niessen¹  Rene Müller-Wille¹  Ivan Platzek²  Max Wächtler¹  Michael Haimerl¹ 

[1] Department of Radiology, University Medical Center Regensburg, Regensburg 93042, Germany;Department of Radiology, University Hospital Carl Gustav Carus Dresden, Dresden, Germany

关键词: Characterization;    Diagnostic performance;    Hepatobiliary;    Gd-EOB-DTPA-enhanced MR imaging;    Focal hepatic lesions;    Magnetic resonance imaging;   

Others  :  1090341
DOI  :  10.1186/1471-2342-13-41

 received in 2013-04-02, accepted in 2013-11-26,  发布年份 2013

【 摘 要 】

Background

Correct characterization of focal solid hepatic lesions has always been a challenge and is of great diagnostic and therapeutic relevance. The purpose of this study was to determine the added value of hepatobiliary phase images in Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) for differentiating focal solid hepatic lesions.

Methods

In this retrospective trial 84 consecutive patients underwent Gd-EOB-DTPA-enhanced MR examinations. MRI was conducted for 64 patients with malignant focal hepatic lesions (34 hepatocellular carcinoma (HCC), 30 metastases) and for 20 patients with benign hepatic lesions (14 focal nodular hyperplasia (FNH), 3 adenoma, 3 hemangioma). Five radiologists independently reviewed three sets of MR images by means of a 5-point confidence scale from score 1 (definitely benign) to score 5 (definitely malignant): set 1: unenhanced images; set 2: unenhanced and Gd-EOB-DTPA-enhanced dynamic images; set 3: hepatobiliary phase images in addition to set 2. Accuracy was assessed by the alternative free-response receiver operating characteristic curve (A_z) and the index of diagnostic performance was calculated.

Results

Diagnostic accuracy was significantly improved by the addition of Gd-EOB-DTPA-enhanced dynamic images: A_z in set 1 was 0.708 and 0.833 in set 2 (P = 0.0002). The addition of hepatobiliary phase images increased the A_z value to 0.941 in set 3 (set 3 vs set 2, P < 0.0001; set 3 vs set 1, P < 0.0001). The index of diagnostic performance was lowest in set 1 (45%), improved in set 2 (71%), and highest in set 3 (94%).

Conclusions

Hepatobiliary phase images obtained after Gd-EOB-DTPA-enhanced dynamic MRI improve the differentiation of focal solid hepatic lesions.

【 授权许可】

   
2013 Haimerl et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 7.

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