Value of discrepancy of the central scar-like structure between dynamic CT and gadoxetate disodium-enhanced MRI in differentiation of focal nodular hyperplasia and hepatocellular adenoma. Issue 139 (June 2021)

• Record Type: Journal Article
• Authors: Park, Hyo Jung; Byun, Jae Ho; Kang, Ji Hun; Kang, Hyo Jeong; Yu, Eunsil; Lee, So Jung; Kim, So Yeon; Won, Hyung Jin; Shin, Yong Moon; Kim, Pyo Nyun
• Is Part Of: European journal of radiology. Issue 139(2021)
• Publication Date: 2021-06
• Subjects: AP arterial phase -- CS central scar -- FNH focal nodular hyperplasia -- HBP hepatobiliary phase -- HCA hepatocellular adenoma -- SI signal intensity -- WI weighted imaging; Focal nodular hyperplasia -- Adenoma -- Liver cell -- Magnetic resonance imaging -- Computed tomography; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2021.109730
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Compared to AP CT, HBP MRI showed more frequent and larger CS-like structures in FNH. The discrepancy in visibility or size of CS-like structure between AP CT and HBP MRI may help differentiate FNH from HCA. Absence of low signal intensity of the non-scarred tumor portion on HBP MRI was also suggestive of FNH than HCA. Abstract: Purpose: To identify the value of discrepancies in the central scar (CS)-like structure between dynamic CT and gadoxetate disodium-enhanced MRI for differentiating FNH from HCA. Methods: This retrospective study included 113 patients with pathologically-diagnosed FNH (n = 80) or HCA (n = 37). CS-like structures were evaluated on arterial phase (AP) CT and hepatobiliary phase (HBP) MRI. Presence of the CS-like structure, its discrepancy in visibility or size between AP CT and HBP MRI and between AP and HBP MRI, and features of non-scarred tumor portion were evaluated by two radiologists. Inter-observer agreement was evaluated by intraclass correlation coefficients (ICCs) and weighted kappa. Univariable and multivariable logistic regression and ROC analysis were performed to explore features differentiating FNH from HCA. Results: Inter-observer agreement was moderate-to-excellent (ICCs≥0.74, kappa≥0.65). On univariable analysis, presence of CS-like structures (P < 0.001), discrepancy of the CS-like structures between AP CT and HBP MRI (73.8 % in FNH; 16.2 % in HCA, P < 0.001) and between AP and HBP MRI (70.0 % in FNH; 16.2 % in HCA, P < 0.001), and the features of non-scarred tumor portion (P ≤ 0.011) were significantly different between FNH and HCA. On multivariable analysis, the discrepancy of CS-like structures between AP CT and HBP MRI, and the absence of low SI of the non-scarred tumor portion on HBP MRI, were suggestive of FNH (P = 0.036 and P < 0.001, respectively; area under the ROC curve, 0.96 [95 % CI, 0.93–0.99]). Conclusion: Evaluation of discrepancy in the visibility or size of CS-like structures between dynamic CT and gadoxetate disodium-enhanced MRI may facilitate the differentiation of FNH from HCA.