Delay Phase in Enhanced MRI Increases Diagnosis of Hepatocellular Carcinoma

Adding a 15-minute delayed phase in extracellular contrast agent (ECA)-enhanced MR imaging may improve the diagnostic performance for hepatocellular carcinoma (HCC) in patients with chronic liver disease, according to a study published in the journal European Radiology.

Researchers from Korea sought to determine the value of a 15-minute delayed phase in ECA-enhanced MR imaging for evaluation of HCC in patients with chronic liver disease.

The researchers assessed the findings of 103 patients with chronic liver disease who underwent ECA-enhanced MRI; 133 lesions consisting of 107 HCCs, 23 benign lesions and three non-HCC malignancies were identified with pathological or clinical diagnosis. MRI images were reviewed by two abdominal radiologists independently using the European Association for the Study of the Liver (EASL) and Liver Imaging Reporting and Data System (LI-RADS) criteria. Imaging features observed in the 15-minute delayed phase were recorded.

The results showed that three or four additional HCCs were diagnosed among the 107 HCCs, according to the EASL criteria by adding the 15-minute delayed phase, increasing sensitivity:

• Reviewer 1, from 69.2–72 percent
• Reviewer 2, from 75.7–79.4 percent

Reviewers 1 and 2 upgraded one and four HCCs from LR-4 to LR-5 based on the LI-RADS, respectively. No additional findings were observed among 23 benign lesions.

The researchers concluded the inclusion of the 15-minute delayed phase in ECA-enhanced MRI may improve the diagnostic performance for HCC in patients with chronic liver disease.