Please use this identifier to cite or link to this item:
http://doi.org/10.25358/openscience-7420
Authors: | Klöckner, Roman Pinto dos Santos, Daniel Kreitner, Karl-Friedrich Leicher-Düber, Anne Weinmann, Arndt Mittler, Jens Düber, Christoph |
Title: | Quantitative assessment of washout in hepatocellular carcinoma using MRI |
Online publication date: | 14-Jul-2022 |
Year of first publication: | 2016 |
Language: | english |
Abstract: | Background Arterial hyperenhancement and washout on computed tomography and magnetic resonance imaging (MRI) are described by all major guidelines as specific criteria for non-invasive diagnosis of hepatocellular carcinoma (HCC). However, publications on the quantitative assessment of washout in MRI are lacking. Therefore, we evaluated a method for quantitatively measuring and defining washout in MRI in order to determine a cutoff value that allows objective HCC diagnosis. Methods We analyzed all patients who underwent liver transplantation for cirrhosis or liver resection for HCC at our institution between 2003 and 2014. Washout was quantitatively investigated by placing a 25-mm2 region of interest (ROI) over each nodule and two 25-mm2 ROIs over adjacent liver parenchyma. The percentage signal ratio (PSR = 100 × ratio of signal intensity of adjacent liver to that of the lesion) was calculated for each series in both groups. Accordingly, this quantitative measurement was compared to a qualitative approach. Results A total of 16 hypervascularized non-HCC nodules and 69 HCC nodules were identified. Interobserver reliability was reasonably good for the measurement of PSRs and readers showed a substantial agreement for the qualitative assessment. In the HCC group, the median PSR was 116.2 at equilibrium and 112.9 in the delayed phase. In the non-HCC group, the median PSR was 93.8 at equilibrium and 96.0 in the delayed phase. Receiver operating characteristic analysis indicated areas under the curve of 0.902 (p < 0.001) and 0.873 (p < 0.001) at equilibrium and in the delayed phase. PSR values of 102 at equilibrium and 101.5 in the delayed phase led to the highest Youden’s index of 0.82 and 0.77, respectively. These PSR cutoffs yielded sensitivities of 82 and 77 %, respectively, with specificities of 100 %. The sensitivity for the qualitative assessment of washout was 88 and 93 % and the specificity was 48 and 56 %. For the classification of HCC, sensitivity yielded 95 and 97 % and specificity was 68 and 56 %, respectively. Conclusion Quantitatively measuring HCC washout in MRI is easy and reproducible. It can objectify and support diagnosis of HCC. However, the quantitative measurement of washout can only serve as one of several components of HCC assessment. |
DDC: | 610 Medizin 610 Medical sciences |
Institution: | Johannes Gutenberg-Universität Mainz |
Department: | FB 04 Medizin |
Place: | Mainz |
ROR: | https://ror.org/023b0x485 |
DOI: | http://doi.org/10.25358/openscience-7420 |
Version: | Published version |
Publication type: | Zeitschriftenaufsatz |
License: | CC BY |
Information on rights of use: | https://creativecommons.org/licenses/by/4.0/ |
Journal: | BMC Cancer 16 |
Pages or article number: | Art. 758 |
Publisher: | BioMed Central |
Publisher place: | London |
Issue date: | 2016 |
ISSN: | 1471-2407 |
Publisher URL: | http://dx.doi.org/10.1186/s12885-016-2797-9 |
Publisher DOI: | 10.1186/s12885-016-2797-9 |
Appears in collections: | DFG-OA-Publizieren (2012 - 2017) |
Files in This Item:
File | Description | Size | Format | ||
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quantitative_assessment_of_wa-20220712210452927.pdf | 1.2 MB | Adobe PDF | View/Open |