Rofo 2017; 189(S 01): S1-S124
DOI: 10.1055/s-0037-1600226
Vortrag (Wissenschaft)
Gastro- und Abdominaldiagnostik
Georg Thieme Verlag KG Stuttgart · New York

Assessment of Gadoxetic Acid-enhanced MRI phases for LI-RADS categorization and non-invasive grading of hepatocellular carcinoma

M Wutschke
1   Universitätsklinikum Jena, Institut für diagnostische und interventionelle Radiologie, Jena
,
T Franiel
2   Universitätsklinikum Jena, Institut für Diagnostische und Interventionelle Radiologie, Jena
,
U Teichgräber
1   Universitätsklinikum Jena, Institut für diagnostische und interventionelle Radiologie, Jena
,
K Katenkamp
3   Universitätsklinikum Jena, Pathologisches Institut, Jena
,
T Lehmann
4   Universitätsklinikum Jena, Institut fuer Medizinische Statistik, Informatik und Dokumentation, Jena
› Author Affiliations
Further Information

Publication History

Publication Date:
23 March 2017 (online)

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Zielsetzung:

This retrospective study evaluated the impact of transitional and hepatobiliary phase on LI-RADS classification and non-invasive grading in patients with hepatocellular carcinoma (HCC).

Material und Methodik:

61 patients with 61 histologically confirmed HCCs underwent MRI with gadoxetic acid. In all phases (arterial [AP], portal venous [PVP], transitional [TP], hepatobiliary [HP]) signal intensities (SI) of HCC and adjacent liver parenchyma were measured. For quantitative assessment ratio between SI of HCC and SI of normal liver were calculated. LI-RADS classification (LR-1 to LR-5) were done in A) LI-RADS major criterions with assessment of washout criterion only in PVP, B) same as A + ancillary feature „transitional phase hypointensity“ and C) same as B + ancillary feature „hepatobiliary phase hypointensity”. Histopathological HCC grading results were correlated with the SI HCC ratio (= SI mass HP/SI mass AP).

Ergebnisse:

None HCC was graded as LR-1 or LR-2. The inclusion of the feature „transitional phase hypointensity“ led to a non-significant upgrading of 5/9 HCC from LR-3 to LR-4 (p = 0.062). The addition of the feature „hepatobiliary phase hypointensity“ led to a statistical significant upgrading of 8/9 HCC from LR-3 to LR-4 (p = 0.008). None HCC with initial LR-4 was upgraded. None lesions were downgraded. The HCC SI ratios between G1 vs. G2/G3 tumors were statistically significant different (p = 0.008).

Schlussfolgerungen:

The addition of transitional and hepatobiliary gadoxetic acid-enhanced MRI phases improves LI-RADS categorization. Quantitative assessment of HCC SI ratio enables non-invasive grading.