Quantitative evaluation of Gd-EOB-DTPA uptake in focal liver lesions by using T1 mapping: differences between hepatocellular carcinoma, hepatic focal nodular hyperplasia and cavernous hemangioma.

Zhenpeng Peng,Chang Li,Shi-Ting Feng,Zi-Ping Li,Tao Chan,Huasong Cai,Yanji Luo,Zhi Dong

doi:10.18632/oncotarget.18918

Zhenpeng Peng, Chang Li + Show 6 more

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https://doi.org/10.18632/oncotarget.18918

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Journal: Oncotarget	Publication Date: Jul 1, 2017
Citations: 17	License type: cc-by

Affiliation: Sun Yat-sen University, University of Hong Kong

Abstract

ObjectivesTo investigate the difference of T1 relaxation time on Gd-EOB-DTPA-enhanced MRI in hepatocellular carcinoma (HCC), hepatic focal nodular hyperplasia (FNH) and cavernous hemangioma of liver (CHL), and to quantitatively evaluate the uptake of Gd-EOB-DTPA in these three focal liver lesions (FLLs).ResultsThe T1P of CHL was significantly higher than those of HCC and FNH (P < 0.05). Reduction of T1 relaxation time on hepatobiliary phase could be observed in all three types of lesions. There were significant differences of T1P, T1E, T1D and T1D% between FNH, CHL and HCC (P < 0.001). Spearman correlation analysis revealed that T1D% was the best indicator for diagnostic differentiation, with a correlation coefficient of 0.702. Discriminant analysis using three variables (T1P, T1E, and T1D%) showed that the classification accuracy was 88.2%.Materials and Methods74 patients diagnosed with focal liver lesions underwent Gd-EOB-DTPA-enhanced MRI including T1 mapping were enrolled, consisting of 51 HCCs, 10 FNHs, and 13 CHLs. T1 relaxation times of these lesions were measured on pre-contrast (T1P) and on hepatobiliary phase images at 20 minute after contrast (T1E). The reduction of T1 relaxation time on hepatobiliary (T1D) and the percentage reduction (T1D%) was calculated. The differences of T1P, T1E, T1D and T1D% in these FLLs were analyzed. The usefulness of these parameters for classification of FLLs was evaluated.ConclusionsUptake of Gd-EOB-DTPA is different between in HCC, FNH and CHL. These three lesions can be distinguished using T1 mapping.

Highlights

Hepatocellular carcinoma (HCC), focal nodular hyperplasia (FNH) and cavernous hemangioma of liver (CHL) are three focal liver lesions (FLLs) commonly encountered in clinical practice
Materials and Methods: 74 patients diagnosed with focal liver lesions underwent Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) including T1 mapping were enrolled, consisting of 51 HCCs, 10 FNHs, and 13 CHLs
We aim to investigate the difference of T1 relaxation time on Gd-EOB-DTPA-enhanced MRI in HCC, FNH and CHL, and to quantitatively evaluate the uptake of Gd-EOB-DTPA in these three FLLs

Summary

Introduction

Hepatocellular carcinoma (HCC), focal nodular hyperplasia (FNH) and cavernous hemangioma of liver (CHL) are three focal liver lesions (FLLs) commonly encountered in clinical practice. Radiological examinations, especially magnetic resonance imaging (MRI), has become the method of choice for detection and characterization of FLLs. The differential diagnosis for FLLs on MRI is based on their differences in morphologic features, signal intensity on non-enhanced sequences, and post Gd-DTPA enhancement patterns. HCCs are still difficult to differentiate from other benign lesions. The existing qualitative assessment methods based on traditional MRI techniques could suffer from interobserver variations, potentially diminishing the accuracy [1,2,3]. Hepatocyte-specific contrast agent enhanced MRI can provide functional and structural information of FLLs, which greatly improves the diagnostic accuracy of these lesions, especially for lesions showing atypical features on conventional sequences [4]

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