Hepatocellular carcinoma: Can LI-RADS v2017 with gadoxetic-acid enhancement magnetic resonance and diffusion-weighted imaging improve diagnostic accuracy?

doi:10.3748/wjg.v25.i5.622

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Feb 7, 2019; 25(5): 622-631
Published online Feb 7, 2019. doi: 10.3748/wjg.v25.i5.622

Table 1 Parameters of diffusion-weighted imaging, T1-weighted imaging, T2-weighted imaging, and VIBE sequence

Parameter	DWI	In/out of phase	T2-weighted imaging	VIBE
Parameter	DWI	T1-weighted imaging	T2-weighted imaging	VIBE
Repetition time (ms)	5600	81	2160	3.95
Echo time (ms)	68	1.4	100	1.92
Field of view (mm²)	380 × 289	400 × 325	433 × 433	400 × 296
Scan matrix	100 × 76	352 × 286	320 × 20288	352 × 256
Slice thickness (mm)	6	6	6	2
Slice gap (mm)	1	2.7	2.7	0
Number of excitation	…	1	2	1

DWI: Diffusion-weighted imaging.

Table 2 Patients’ baseline characteristics

Characteristic	Value
Clinical information
Age (yr)	50.31 ± 10.87 (range: 26-77)
Male/female	157/46
Etiology of liver disease
Hepatitis B virus	194 (95.57%)
Hepatitis C virus	8 (3.94%)
Both hepatitis B and C virus	1 (0.49%)
Tumor size (cm)	Median 5.3 (range: 1.1-12.8)
AFP level (ng/mL)	102.3 ng/mL (range 1.2-15926.0)
Serum AST (≥ 35 IU/L)	107 (52.7%)
Serum ALT (≥ 40 IU/L)	82 (40.4%)

AFP: Alpha-fetoprotein; ALT: Alanine aminotransferase; AST: Aspartate aminotransaminase.

Table 3 Sensitivity, specificity, and accuracy of the liver imaging reporting and data system category for diagnosing hepatocellular carcinoma with gadoxetic-acid enhanced magnetic resonance imaging

Group	DWI	Sensitivity (100%)	Specificity (100%)	Accuracy (100%)	PPV (100%)	NPV (100%)	Youden index
LR-5	A-DWI	61.2 (101/165)	92.5 (74/80)	71.4 (175/245)	94.4 (101/107)	53.6 (74/138)	0.537
LR-5	P-DWI	61.2 (101/165)	92.5 (74/80)	71.4 (175/245)	94.4 (101/107)	53.6 (74/138)	0.537
LR-4/5	A-DWI	73.9 (122/165)	80 (64/80)	75.9 (186/245)	88.4(122/138)	59.8 (64/107)	0.539
LR-4/5	P-DWI	87.9 (145/165)	80 (64/80)	85.3 (209/245)	90.1 (145/161)	76.2 (64/84)	0.679
LR-4/5/M	A-DWI	75.8 (125/165)	58.8 (47/80)	70.2 (172/245)	79.1 (125/158)	54 (47/87)	0.346
LR-4/5/M	P-DWI	87.9 (145/165)	58.8 (47/80)	78.4 (192/245)	81.5 (145/178)	70.1 (47/67)	0.467
LR-4/5/TIV	A-DWI	75.8 (125/165)	75 (60/80)	75.5 (185/245)	86.2 (125/145)	60 (60/100)	0.508
LR-4/5/TIV	P-DWI	89.7 (148/165)	75 (60/80)	84.9 (208/245)	88.1 (148/168)	77.9 (60/77)	0.647

A-DWI: Absence of diffusion-weighted imaging; P-DWI: Presence of diffusion-weighted imaging; PPV: Positive predictive value; NPV: Negative predictive value.

Citation: Zhang T, Huang ZX, Wei Y, Jiang HY, Chen J, Liu XJ, Cao LK, Duan T, He XP, Xia CC, Song B. Hepatocellular carcinoma: Can LI-RADS v2017 with gadoxetic-acid enhancement magnetic resonance and diffusion-weighted imaging improve diagnostic accuracy? World J Gastroenterol 2019; 25(5): 622-631
URL: https://www.wjgnet.com/1007-9327/full/v25/i5/622.htm
DOI: https://dx.doi.org/10.3748/wjg.v25.i5.622