Profiling hepatocellular carcinoma aggressiveness with contrast-enhanced ultrasound and gadoxetate disodium-enhanced MRI: An intra-individual comparative study based on the Liver Imaging Reporting and Data System. Issue 154 (September 2022)

• Record Type: Journal Article
• Authors: Yang, Jie; Jiang, Hanyu; Xie, Kunlin; Bashir, Mustafa R.; Wan, Haifeng; Huang, Jiayan; Qin, Yun; Chen, Jie; Lu, Qiang; Song, Bin
• Is Part Of: European journal of radiology. Issue 154(2022)
• Publication Date: 2022-09
• Subjects: Hepatocellular carcinoma -- Aggressiveness -- Contrast-enhanced ultrasound -- Gadoxetate disodium-enhanced MRI; CEUS Contrast-enhanced ultrasound -- EOB-MRI Gadexetate disodium-enhanced magnetic resonance imaging -- ES Edmondson-Steiner -- HCC Hepatocellular carcinoma -- LI-RADS Liver Imaging Reporting and Data System -- MVI Microvascular invasion -- TIV Tumor-in-vein; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2022.110397
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Marked discrepancies were found between contrast-enhanced ultrasound (CEUS) and gadoxetate disodium-enhanced MRI (EOB-MRI) in evaluating LI-RADS features and categories, especially for LR-TIV and LR-M. Compared with EOB-MRI, CEUS showed superior diagnostic specificity for macrovascular invasion at pathology. LR-M features on EOB-MRI provided more information regarding tumor grade and MVI status in HCC patients than CEUS. Abstract: Purpose: Contrast-enhanced ultrasound (CEUS) and gadoxetate disodium-enhanced MRI (EOB-MRI) may synergize in profiling hepatocellular carcinoma (HCC) aggressiveness considering distinct imaging traits. This study aimed to intra-individually compare CEUS and EOB-MRI with Liver Imaging Reporting and Data System (LI-RADS) in assessing HCC aggressiveness. Method: From January 2015 to November 2020, consecutive at-risk patients with surgically-confirmed HCC who underwent both preoperative CEUS and EOB-MRI examinations were retrospectively enrolled. Image analyses were conducted independently by two masked radiologists for CEUS and EOB-MRI, respectively. The diagnostic performance of each modality for macrovascular invasion against pathology was evaluated and compared with the McNemar's test, while Edmondson-Steiner grade and the presence of microvascular invasion (MVI) were compared between patients with and without LR-M features on each modality. Results: A total of 140 patients (mean age, 51.9 years ± 11.0; 116 men) were included. Inter-modality agreement was poor (κ = -0.087 ∼ 0.139) for major LI-RADS features and moderate (κ = 0.449) for overall LI-RADS categorization, and LR-TIV and LR-M were the top sources of inter-modality variations. Although CEUS demonstrated significantly higher specificity for diagnosing macrovascular invasion (96% vs. 89%, P =.02), LR-M features on EOB-MRI were more effective in identifying higher Edmondson-Steiner grades ( P =.01) and MVI ( P =.02). Conclusions: Marked discrepancies were found between CEUS and EOB-MRI in evaluating LI-RADS features and categories. Whereas CEUS showed superior diagnostic specificity for macrovascular invasion, LR-M features on EOB-MRI provided more information regarding tumor grade and MVI status in HCC patients.