1. Gd-EOB-DTPA-Enhanced MRI is Better than MDCT in Decision Making of Curative Treatment for Hepatocellular Carcinoma
- Author
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Seung Kew Yoon, Si Hyun Bae, Eun Sun Jung, Dong Goo Kim, Jeong Won Jang, Young Kyoung Yoo, Young Joon Lee, Sun Hong Yoo, Jong Young Choi, and Sung Eun Rha
- Subjects
Gadolinium DTPA ,Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Radiofrequency ablation ,medicine.medical_treatment ,Decision Making ,Contrast Media ,Liver transplantation ,law.invention ,Text mining ,Surgical oncology ,law ,Multidetector Computed Tomography ,medicine ,Carcinoma ,Humans ,cardiovascular diseases ,Neoplasm Staging ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,Magnetic resonance imaging ,Retrospective cohort study ,Middle Aged ,Prognosis ,medicine.disease ,Magnetic Resonance Imaging ,Oncology ,Hepatocellular carcinoma ,cardiovascular system ,Female ,Surgery ,Radiology ,business ,Follow-Up Studies - Abstract
We assessed the change in the therapeutic decision among curative treatments after adding Gd-EOB-DTPA-enhanced MRI to triple-phase MDCT for patients with early-stage HCC. This study retrospectively investigated two groups: 33 pathologically confirmed HCC patients after liver transplantation in group 1; 34 HCC patients without pathology in group 2. In group 1, we simulated the therapeutic decision-making process by pretransplant MDCT and Gd-EOB-DTPA-enhanced MRI. In group 2, including the 34 early-stage HCC patients consecutively enrolled, we investigated the change of therapeutic decision after adding Gd-EOB-DTPA-enhanced MRI to MDCT. In the simulation from group 1, after adding Gd-EOB-DTPA-enhanced MRI, 33.3 % (11/33 patients) of treatment decisions were changed from the decision based on MDCT alone. Among 22 patients considered eligible for resection and 33 patients for radiofrequency ablation, the therapeutic decision was changed for 10 patients in the surgical group and 4 patients for the RFA group (45.5 and 12.1 %). In group 2, the rate of change in the therapeutic decision after adding Gd-EOB-DTPA-enhanced MRI to MDCT was 41.2 % (14/34 patients). In group 1 with explants pathology, the median diameter of HCCs not detected by MDCT but detected by Gd-EOB-DTPA-enhanced MRI was 1.15 cm (0.3–3.0 cm). The median diameter of HCCs seen only in the explanted liver was 1.0 cm (0.3–1.7 cm), and 60.7 % of them were well-differentiated HCCs. This study suggests that performing Gd-EOB-DTPA-enhanced MRI before deciding on curative treatment for early-stage HCC may improve the accuracy of treatment decision for early-stage HCC.
- Published
- 2013