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RESEARCH PRODUCT

Enhancing capsule in hepatocellular carcinoma: intra-individual comparison between CT and MRI with extracellular contrast agent

Fanny BonvaletC. HobeikaValérie ParadisMarco Dioguardi BurgioFrançois CauchyAurélie BeaufrèreRoberto CannellaMohamed BouattourRiccardo SartorisLoïc TrapaniValérie VilgrainMaxime Ronot

subject

Gadolinium DTPAMaleCarcinoma HepatocellularContrast MediaComputed tomographySensitivity and SpecificityMcNemar's testExtracellularmedicineHumansRadiology Nuclear Medicine and imagingCapsule Computed tomography Extracellular contrast agent Hepatocellular carcinoma Magnetic resonance imagingAgedRetrospective StudiesRadiological and Ultrasound Technologymedicine.diagnostic_testbusiness.industryLiver NeoplasmsCapsuleMagnetic resonance imagingRetrospective cohort studyGeneral MedicineMiddle Agedmedicine.diseaseMagnetic Resonance ImagingHepatocellular carcinomaFemaleTomography X-Ray ComputedSettore MED/36 - Diagnostica Per Immagini E RadioterapiabusinessNuclear medicineKappa

description

Purpose: The purpose of this study was to compare the value of contrast-enhanced computed tomography (CT) to that of magnetic resonance imaging obtained with extracellular contrast agent (ECA-MRI) for the diagnosis of a tumor capsule in hepatocellular carcinoma (HCC) using histopathologic findings as the standard of reference. Materials and methods: This retrospective study included patients with pathologically-proven resected HCCs with available preoperative contrast-enhanced CT and ECA-MRI examinations. Two blinded radiologists independently reviewed contrast-enhanced CT and ECA-MRI examinations to assess the presence of an enhancing capsule. The histopathological analysis of resected specimens was used as reference for the diagnosis of a tumor capsule. The sensitivity and specificity of CT and ECA-MRI for the diagnosis of a tumor capsule were determined, and an intra-individual comparison of imaging modalities was performed using McNemar test. Inter-reader agreement was assessed using Kappa test. Results: The study population included 199 patients (157 men, 42 women; mean age: 61.3 +/- 13.0 [SD] years) with 210 HCCs (mean size 56.7 +/- 43.7 [SD] mm). A tumor capsule was present in 157/210 (74.8%) HCCs at histopathologic analysis. Capsule enhancement was more frequently visualized on ECA-MRI (R1, 68.6%; R2, 71.9%) than on CT (R1, 44.3%, P < 0.001; R2, 47.6%, P < 0.001). The sensitivity of ECA-MRI was better for the diagnosis of histopathological tumor capsule (R1, 76.4%; R2, 79.6%; P < 0.001), while CT had a greater specificity (R1, 84.9%; R2, 83.0%; P < 0.001). Inter-reader agreement was moderate both on CT (kappa = 0.55; 95% confidence interval [CI]: 0.43-0.66) and ECA-MRI (kappa = 0.57; 95% CI: 0.45-0.70). Conclusion: Capsule enhancement was more frequently visualized on ECA-MRI than on CT. The sensitivity of ECA-MRI was greater than that of CT, but the specificity of CT was better than that of ECA-MRI. (c) 2021 Societe francaise de radiologie. Published by Elsevier Masson SAS. All rights reserved.

yearjournalcountryeditionlanguage
2021-12-01Diagnostic and Interventional Imaging
https://doi.org/10.1016/j.diii.2021.06.004