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Background Arterial hyperenhancement and washout on computed tomography and magnetic resonance imaging (MRI) are described by all major guidelines as specific criteria for non-invasive diagnosis of hepatocellular carcinoma (HCC). However, publications on the quantitative assessment of washout in MRI are lacking. Therefore, we evaluated a method for quantitatively measuring and defining washout in MRI in order to determine a cutoff value that allows objective HCC diagnosis. Methods We ana...Background Arterial hyperenhancement and washout on computed tomography and magnetic resonance imaging (MRI) are described by all major guidelines as specific criteria for non-invasive diagnosis of hepatocellular carcinoma (HCC). However, publications on the quantitative assessment of washout in MRI are lacking. Therefore, we evaluated a method for quantitatively measuring and defining washout in MRI in order to determine a cutoff value that allows objective HCC diagnosis. Methods We analyzed all patients who underwent liver transplantation for cirrhosis or liver resection for HCC at our institution between 2003 and 2014. Washout was quantitatively investigated by placing a 25-mm2 region of interest (ROI) over each nodule and two 25-mm2 ROIs over adjacent liver parenchyma. The percentage signal ratio (PSR = 100 × ratio of signal intensity of adjacent liver to that of the lesion) was calculated for each series in both groups. Accordingly, this quantitative measurement was compared to a qualitative approach. Results A total of 16 hypervascularized non-HCC nodules and 69 HCC nodules were identified. Interobserver reliability was reasonably good for the measurement of PSRs and readers showed a substantial agreement for the qualitative assessment. In the HCC group, the median PSR was 116.2 at equilibrium and 112.9 in the delayed phase. In the non-HCC group, the median PSR was 93.8 at equilibrium and 96.0 in the delayed phase. Receiver operating characteristic analysis indicated areas under the curve of 0.902 (p » weiterlesen» einklappen

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DDC Sachgruppe:
Medizin