J Korean Soc Radiol.  2021 Sep;82(5):1218-1230. 10.3348/jksr.2020.0172.

Diagnostic Performance of Simulated Abbreviated MRI for Early-Stage Hepatocellular Carcinoma Screening: A Comparison to Conventional Dynamic Contrast-Enhanced MRI

• Lim ES
• Kim SM
• Shin SS
• Heo SH
• Lee JE
• Jeong YY

• KMID: 2520703
• DOI: http://doi.org/10.3348/jksr.2020.0172

Abstract

Purpose
To compare the per-patient diagnostic performance of simulated abbreviated MRI (AMRI) to that of conventional MRI (CMRI) with full-sequence dynamic gadoxetic acid (GA) enhancement for early-stage hepatocellular carcinoma (HCC) screening in high-risk patients.
Materials and Methods
A total of 201 consecutive patients at high-risk for HCC, who underwent 3T liver MRI, were included in this retrospective study. The AMRI protocol comprised T2-weighted imaging, hepatobiliary phase imaging after GA injection, and diffusion-weighted imaging. For each patient, two AMRI and CMRI image sets were independently reviewed by two radiologists. Inter-reader agreement was assessed using Cohen’s kappa value. A composite reference standard was used to determine the diagnostic performance of each image set for each reader.
Results
A total of 93 HCCs were detected in 79 patients. The inter-reader agreement was almost perfect for both image sets (κ = 0.839, 0.948). In AMRI, the per-patient sensitivity and negative predictive values (NPV) were 94.9% and 96.4%, respectively. In CMRI, the per-patient sensitivity and NPV were 96.2% and 97.5%, respectively.
Conclusion
AMRI, using only three sequences, had a comparable diagnostic performance to CMRI in screening early-stage HCC. AMRI could be an alternative HCC screening tool for highrisk HCC patients.

Keyword

Hepatocellular Carcinoma; Liver; Magnetic Resonance Imaging