Liver Cirrhosis Research Today is a free monthly online journal that collates and summarizes the latest research about Liver Cirrhosis, including details on alcohol, treatment, drugs, effects, causes. | ||||||||
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Double-contrast MRI for accurate staging of hepatocellular carcinoma in patients with cirrhosis.Hanna RF, Kased N, Kwan SW, Gamst AC, Santosa AC, Hassanein T, Sirlin CB Department of Radiology, Division of Body Imaging, University of California, San Diego, 200 W Arbor Dr., San Diego, CA 92103-8756, USA. OBJECTIVE: The aim of this study was to evaluate the accuracy of a double-contrast MRI protocol in staging of hepatocellular carcinoma (HCC) in patients with cirrhosis. MATERIALS AND METHODS: This cross-sectional study was performed at a tertiary liver care center. Forty-eight patients with cirrhosis underwent double-contrast MRI for clinical care and liver transplantation. For each MRI examination, superparamagnetic iron oxide was infused, and 2D T2*-weighted spoiled gradient-recalled echo and T2-weighted echo-train spin-echo MR images were obtained for assessment of phagocytic function. Immediately afterward, a low-molecular-weight gadolinium compound was injected, and 3D T1-weighted spoiled gradient-recalled echo images were acquired dynamically for assessment of vascularity. Two blinded radiologists independently reviewed all MR images and assigned per-lesion and per-patient cancer confidence scores to determine the American Liver Tumor Study Group tumor stage. The imaging-based cancer scores and tumor stages were correlated with pathology reports. Performance parameters were computed for imaging-based measurements. RESULTS: Of the 48 study subjects, 25 had HCC (three, T1; 18, T2; one, T3; one, T4a; two, T4b). In total, there were 37 HCC nodules. The accuracy of MRI in prediction of pathologic tumor stage was 81-85% depending on the radiologist. Per-patient and per-lesion sensitivity in the diagnosis of HCC were 96% and 81% for one radiologist and 96% and 89% for the other. CONCLUSION: A double-contrast MRI protocol has high accuracy in staging of HCC in patients with cirrhosis. Published 20 December 2007 in AJR Am J Roentgenol, 190(1): 47-57.
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