The Diagnostic Performance of Liver MRI without Intravenous Contrast for Detecting Hepatocellular Carcinoma: A Case-Controlled Feasibility Study.
10.3348/kjr.2018.19.4.568
- Author:
Seunghee HAN
1
;
Joon Il CHOI
;
Michael Yong PARK
;
Moon Hyung CHOI
;
Sung Eun RHA
;
Young Joon LEE
Author Information
1. Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea. dumkycji@gmail.com
- Publication Type:Original Article
- Keywords:
Hepatocellular carcinoma;
Liver;
MRI;
Surveillance;
Screening;
Non-contrast
- MeSH:
Carcinoma, Hepatocellular*;
Case-Control Studies*;
Diagnosis;
Diagnostic Tests, Routine;
Diffusion;
Feasibility Studies*;
Humans;
Liver Diseases;
Liver*;
Magnetic Resonance Imaging*;
Mass Screening;
Sensitivity and Specificity
- From:Korean Journal of Radiology
2018;19(4):568-577
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To preliminarily evaluate the diagnostic performance of an unenhanced MRI for detecting hepatocellular carcinoma (HCC) with a case-control study design. MATERIALS AND METHODS: The case group consisted of 175 patients with initially-diagnosed HCC, who underwent a 3T liver MRI. A total of 237 HCCs were identified. The number of HCCs that were smaller than 1 cm, 1 cm ≤ and < 2 cm, and ≥ 2 cm were 19, 105, and 113, respectively. For the control group, 72 patients with chronic liver disease, who did not have HCC, were enrolled. Two radiologists independently reviewed the T2 half-Fourier acquisition single-shot turbo spin echo, T2 fast spin echos with fat saturation, T1 gradient in- and out-of-phase images, and diffusion-weighted images/apparent diffusion coefficient maps to detect HCC. Per-patient analyses were performed to evaluate the sensitivity and specificity of the non-contrast MRI for diagnosing HCC. Furthermore, the per-lesion sensitivity was also calculated according to tumor size. RESULTS: In the per-patient analyses, the sensitivity and specificity of reader 1 were 86.3% (151/175) and 87.5% (63/72), respectively; while those of reader 2 were 82.9% (145/175) and 76.4% (55/72), respectively. When excluding HCCs smaller than 1 cm, the sensitivity of reader 1 and 2 were 88.0% (147/167) and 86.2% (144/167), respectively. In the per-lesion analyses, the sensitivities of reader 1 and reader 2 were 75.9% (180/237) and 70.5% (167/237), respectively. CONCLUSION: The per-patient sensitivity and specificity of non-contrast MRIs were within a reasonable range for the initial diagnosis of HCC. Non-contrast MRIs may have a potential for surveillance of HCC. Further confirmatory diagnostic test accuracy studies are needed.
