Diagnostic Value of CT Delayed Phase Images Added to Gd-EOB-DTPA MRI for HCC Diagnosis in LR-3/4 Lesions

Figures & data

Figure 1 Flowchart of the inclusion and exclusion criteria.

Table 1 Characteristics of the Study Population

Variable	HCC (n = 52)	Non-HCC (n = 40)	P value
Age (year)	56.4±9.2	55.9±8.3	0.414
Gender(Male/Female)	34/18	26/14	0.571
Cirrhosis	30	24	0.497
HBV	36	22	0.118
HCV	3	2	0.624
Alcoholic	5	3	0.512
Child-Pugh A/B /C	38/10/4	29/8/3	0.996
Diameter(cm)	3.1±1.4	2.6±1.8	0.192
AFP(≥20.0 ng/mL)	26	9	0.008*

Note: *Values with statistical difference.

Abbreviations: HBV, Hepatitis B viral; HCV, Hepatitis C viral; AFP, α-fetoprotein; HCC, hepatocellular carcinoma.

Table 2 Tumor Features of LI-RADS

Variable	HCC (n = 52)	Non-HCC (n = 40)	k value	P value
MRI Major features
APHE	41	30	0.926	0.424
Washout	33	6	0.780	<0.001*
Enhancing capsule	28	7	0.835	0.001*
MRI HCC-specific auxiliary features
Non-enhancing capsule	1	0	1.000	0.565
Nodule-in-nodule architecture	4	2	0.776	0.470
Mosaic architecture	13	8	0.918	0.378
Fat in mass	7	5	0.860	0.574
Blood products in mass	5	3	0.820	0.512
CT washout	37	7	0.835	<0.001*

Note: *Values with statistical difference.

Abbreviations: LI-RADS, Liver Imaging Reporting and Data System; APHE, nonrim arterial phase hyperenhancement; HCC, hepatocellular carcinoma.

Figure 2 56-year-old man with cirrhosis and HCC. (a) APHE of Gd-EOB-DTPA MRI. Figure (b) shows no washout and no capsule in PVP of Gd-EOB-DTPA MRI. Tumor diameter > 2cm, and LR-4. Figure (c) shows washout in delayed phase of CT. Adding CT delayed phase images to Gd-EOB-DTPA MRI, the lesion was classified as LR-5.

Figure 3 52-year-old man with cirrhosis and HCC. Figure (a) shows APHE of Gd-EOB-DTPA MRI. Figure (b) shows no washout and no capsule in PVP of Gd-EOB-DTPA MRI. Tumor diameter > 2cm, and LR-4. Figure (c) shows washout and enhancing capsule in delayed phase of CT. Adding CT delayed-phase images to Gd-EOB-DTPA MRI, the lesion was classified as LR-5.

Table 3 Logistic Regression Analysis for the Diagnosis of HCC

Model	Variable	B	OR	95% CI	P value
Model 1
	MRI washout	2.336	10.345	3.460–30.930	<0.001*
	Enhancing capsule	1.623	0.197	0.065–0.595	0.004*
Model 2
	MRI and (or) CT washout	2.958	0.052	0.016–0.172	<0.001*
	Enhancing capsule	2.024	0.132	0.139–0.449	0.001*

Note: *Values with statistical difference.

Abbreviations: HCC, hepatocellular carcinoma; CI, confidence interval.

Figure 4 The blue solid line was the ROC of model 1. The green dotted line is the ROC of model 2.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.