Background & Aims: Although gadoxetate disodium-enhanced magnetic resonance imaging (MRI) shows higher sensitivity for diagnosing hepatocellular carcinoma (HCC), its arterial-phase images may be unsatisfactory because of weak arterial enhancement. We investigated the clinical effectiveness of arterial subtraction images from gadoxetate disodium-enhanced MRI for diagnosing early-stage HCC using the Liver Imaging Reporting and Data System (LI-RADS) v2018.
Methods: In 258 patients at risk of HCC who underwent gadoxetate disodium-enhanced MRI in 2016, a total of 372 hepatic nodules (273 HCCs, 18 other malignancies, and 81 benign nodules) of 3.0 cm or smaller were retrospectively analyzed. Final diagnosis was assessed histopathologically or clinically (marginal recurrence after treatment or change in lesion size on follow-up imaging). The detection rate for arterial hyperenhancement was compared between ordinary arterial-phase and arterial subtraction images, and the benefit of arterial subtraction images in diagnosing HCC using LI-RADS was assessed.
Results: Arterial subtraction images had a significantly higher detection rate for arterial hyperenhancement than ordinary arterial-phase images, both for all hepatic nodules (72.3% vs. 62.4%, p <0.001) and HCCs (91.9% vs. 80.6%, p <0.001). Compared with ordinary arterial-phase images, arterial subtraction images significantly increased the sensitivity of LI-RADS category 5 for diagnosis of HCC (64.1% [173/270] vs. 55.9% [151/270], p <0.001), without significantly decreasing specificity (92.9% [91/98] vs. 94.9% [93/98], p = 0.155). For histopathologically confirmed lesions, arterial subtraction images significantly increased sensitivity to 68.8% (128/186) from the 61.3% (114/186) of ordinary arterial-phase images (p <0.001), with a minimal decrease in specificity to 84.8% (39/46) from 89.1% (41/46) (p = 0.151).
Conclusions: Arterial subtraction images of gadoxetate disodium-enhanced MRI can significantly improve the sensitivity of early-stage HCC diagnosis using LI-RADS, without a significant decrease in specificity.
Lay Summary: Gadoxetate disodium-enhanced magnetic resonance imaging is an imaging technique with a high sensitivity for the diagnosis of hepatocellular carcinoma. However, arterial-phase images may be unsatisfactory because of weak arterial enhancement. We found that using arterial subtraction images led to clinically meaningful improvements in the diagnosis of early-stage hepatocellular carcinoma.
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http://dx.doi.org/10.1016/j.jhep.2019.05.005 | DOI Listing |
Cancers (Basel)
December 2024
Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan.
Skull base tumors such as meningiomas and schwannomas are often pathologically benign. However, surgery for these tumors poses significant challenges because of their proximity to critical structures such as the brainstem, cerebral arteries, veins, and cranial nerves. These structures are compressed or encased by the tumor as they grow, increasing the risk of unintended injury to these structures, which can potentially lead to severe neurological deficits.
View Article and Find Full Text PDFCureus
December 2024
Department of Ophthalmology, Hospital University Kebangsaan Malaysia, Kuala Lumpur, MYS.
We report a rare case of a missed intracavernous internal carotid artery dissecting aneurysm occurring as a complication of the base of skull fracture with severe brain injury causing acute cavernous sinus syndrome with permanent vision loss. A 31-year-old Myanmar lady had an alleged motor vehicle accident and suffered severe traumatic brain injury with multiple intracranial bleeds, multiple facial bone and base of skull fractures, and limb fractures. At one week post-trauma, she had severe right eye proptosis with vision loss, ophthalmoplegia, chemosis, and high intraocular pressure.
View Article and Find Full Text PDFJ Imaging Inform Med
January 2025
Department of Radiology, UC Davis School of Medicine, University of California, Davis, 4860 Y Street, Suite 3100, Sacramento, CA, 95817-2307, USA.
Purpose: To explore the information in routine digital subtraction angiography (DSA) and evaluate deep learning algorithms for automated identification of anatomic location in DSA sequences.
Methods: DSA of the abdominal aorta, celiac, superior mesenteric, inferior mesenteric, and bilateral external iliac arteries was labeled with the anatomic location from retrospectively collected endovascular procedures performed between 2010 and 2020 at a tertiary care medical center. "Key" images within each sequence demonstrating the parent vessel and the first bifurcation were additionally labeled.
Objective: To investigate the value of routine T2-weighted magnetic resonance imaging (MRI) and contrast-enhanced magnetic resonance angiography (CE-MRA) sequences in locating the fistula level of spinal arteriovenous fistula (SAVF).
Methods: Retrospectively analyzed the radiological findings of patients with SAVF diagnosed by surgery from May 2018 to September 2024. All patients completed spinal CE-MRA and routine T2-weighted MRI.
Surg Neurol Int
December 2024
Department of Surgery, Section of Neurosurgery, Aga Khan University, Karachi, Pakistan.
Background: Intracranial arteriovenous malformations (AVMs) are extremely rare in the pediatric population, with an estimated prevalence of 0.014-0.028%.
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