Efficacy of fusion imaging combining sonography and hepatobiliary phase MRI with Gd-EOB-DTPA to detect small hepatocellular carcinoma.

Abstract

OBJECTIVE:

We evaluated the efficacy of fusion imaging that fuses conventional sonography images with hepatobiliary phase contrast-enhanced MR images obtained with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) as the reference image for the detection of hepatocellular carcinomas (HCCs).

SUBJECTS AND METHODS:

Eighty-seven HCCs with a maximum diameter of between 1 and 3 cm at the time of diagnosis were enrolled in this prospective study. We compared the detection rates of HCCs using three sonography modalities: conventional sonography, late phase of contrast-enhanced sonography with Sonazoid, and fusion imaging combining conventional sonography and the hepatobiliary phase of contrast-enhanced MRI with Gd-EOB-DTPA as the reference image. The comparisons were made using the McNemar test.

RESULTS:

The detection rate of HCCs using fusion imaging (98%, 85/87) was significantly higher than the detection rates using conventional sonography (76%, 66/87) and contrast-enhanced sonography (83%, 72/87) (p<0.01, for both). For small HCCs (maximum diameter, 1-2 cm), the detection rate using fusion imaging (97%, 59/61) was also significantly higher than those using conventional sonography (66%, 40/61) and contrast-enhanced sonography (80%, 49/61) (p<0.01, for both). The detection rate for atypical HCCs was also significantly higher using fusion imaging (95%, 18/19) than using conventional sonography (53%, 10/19) and contrast-enhanced sonography (26%, 5/19) (p<0.01, for both).

CONCLUSION:

Fusion imaging combining conventional sonography and the hepatobiliary phase of contrast-enhanced MRI with Gd-EOB-DTPA is more sensitive than conventional sonography or contrast-enhanced sonography for detecting HCCs, especially small or atypical HCCs.

• Authors: Yosuke Kunishi, Kazushi Numata, Manabu Morimoto, Masahiro Okada, Tetsuji Kaneko, Shin Maeda, Katsuaki Tanaka
• Journal: AJR. American journal of roentgenology (AJR Am J Roentgenol) Vol. 198 Issue 1 Pg. 106-14 (Jan 2012) ISSN: 1546-3141 [Electronic] United States
• PMID: 22194485 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• Ferric Compounds
• Oxides
• Sonazoid
• gadolinium ethoxybenzyl DTPA
• Iron
• Gadolinium DTPA

Topics

• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular (diagnosis, diagnostic imaging)
• Contrast Media
• Female
• Ferric Compounds
• Gadolinium DTPA
• Humans
• Image Enhancement (methods)
• Image Interpretation, Computer-Assisted
• Iron
• Liver Neoplasms (diagnosis, diagnostic imaging)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Oxides
• Prospective Studies
• Tomography, X-Ray Computed
• Ultrasonography