Prediction of macroscopic findings of hepatocellular carcinoma on hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging: Correlation with pathology

Aim: We aimed to correlate the macroscopic and magnetic resonance imaging (MRI) findings of hepatocellular carcinomas (HCC).

Methods: This was a multicenter study, whose study protocol was approved by each institutional review board. One hundred and forty-six resected nodules in 124 patients who had received a preoperative hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MRI (EOB-MRI) were analyzed. In both findings, we compared the diameter of HCC and macroscopic types divided into five types: (i) small nodular type with indistinct margin (SN-IM); (ii) simple nodular type (with distinct margin) (SN-DM); (iii) simple nodular type with extranodular growth (SN-EG); (iv) confluent multinodular type (CMN); and (v) infiltrative type (IF).

Results: The diameters in each finding (Dsurg and DMRI ) were significantly correlated (R = 0.961), although Dsurg was larger than DMRI (P = 0.0216). There were significant differences between Dsurg in SN-IM and the other groups (P < 0.0001). Sensitivity, specificity and accuracy were 5.3, 99.2 and 87; 84.8, 62.7 and 81.4; 58.1, 91.3 and 84.2; 70.6, 91.5 and 89, in SN-IM, SN-DM, SN-EG and CMN, respectively. The kappa value of every size was as follows: all sizes, 0.45; 20 mm or less, 0.23; more than 20 mm, 0.56.

Conclusion: EOB-MRI could predict the macroscopic pathological findings except for SN-IM. Small tumor size might be helpful to diagnose SN-IM.