Double-contrast magnetic resonance imaging of hepatocellular carcinoma after transarterial chemoembolization |
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Authors: | Nicolae Bolog Thomas Pfammatter Beat Müllhaupt Gustav Andreisek Dominik Weishaupt |
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Institution: | (1) Department of Magnetic Resonance, Institute of Diagnostic Radiology, Zurich, Switzerland;(2) Department of Gastroenterology, University Hospital, Zurich, Switzerland |
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Abstract: | Background The purpose of this study was to assess the accuracy of double-contrast magnetic resonance (MR) imaging for the treatment
response evaluation of hepatocellular carcinoma (HCC) in cirrhotic liver after transarterial chemoembolization (TACE).
Methods Twenty-two patients with 30 HCC nodules treated by TACE underwent double-contrast MR imaging 1 month after treatment. MR images
were obtained before and after the sequential administration of superparamagnetic iron oxide (SPIO) and gadopentetate dimeglumine
contrast agent within the same imaging session. Two observers retrospectively assessed all treated nodules for evidence of
residual viable tumor after TACE. The diagnostic performance of gadolinium-enhanced, SPIO-enhanced, and double-contrast enhanced
images was calculated. Histopathological and angiographical findings served as standard of reference. Receiver operating characteristic
curves and areas under the curves (A
z) were calculated.
Results Double-contrast technique (A
z = 0.95) was significantly (p = 0.036) more accurate than SPIO-enhanced technique (A
z = 0.92) and gadolinium-enhanced technique (p = 0.005) (A
z = 0.81) in viable tumor detection after TACE. Double-contrast technique was significantly more sensitive (92%) than SPIO-enhanced
technique (80%) and gadolinium-enhanced technique (68%). Kappa values for interobserver agreement ranged from 0.67 to 0.87
and were significantly different from zero (all p < 0.001).
Conclusions Compared to gadolinium-enhanced and SPIO-enhanced techniques, double-contrast technique significantly improves the detection
of viable tumor in HCC after TACE. |
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Keywords: | Cirrhosis Superparamagnetic iron oxide (SPIO) Transarterial chemoembolization (TACE) Hepatocellular carcinoma (HCC) Double-contrast MR imaging |
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