Contrast-enhanced computed tomography plus gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging for gross classification of hepatocellular carcinoma
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Chuang Chen1,2,*, Hui Zhao3,*, Xu Fu4,*, LuoShun Huang4, Min Tang5, XiaoPeng Yan4, ShiQuan Sun4, WenJun Jia4, Liang Mao4, Jiong Shi6, Jun Chen6, Jian He5, Jin Zhu7,8, YuDong Qiu1,4
1Department of Hepatopancreatobiliary Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, Jiangsu, China
2Department of Hepatopancreatobiliary Surgery, Huai'an Hospital Affiliated to Xuzhou Medical University, Second People's Hospital of Huai'an City, Huai'an 223002, Jiangsu, China
3Department of Hepatopancreatobiliary Surgery, Nanjing Medical University Affiliated Wuxi Second Hospital, Wuxi 214001, Jiangsu, China
4Department of Hepatopancreatobiliary Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
5Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
6Department of Pathology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
7Key Laboratory of Antibody Technique of Ministry of Health, Nanjing Medical University, Nanjing 210029, Jiangsu, China
8Huadong medical Institute of Biotechniques, Nanjing 210029, Jiangsu, China
*These authors contributed equally to this work
Jin Zhu, email: firstname.lastname@example.org
YuDong Qiu, email: email@example.com
Keywords: hepatocellular carcinoma, CE-CT, EOB-MRI, gross classification, imaging
Received: October 04, 2016 Accepted: February 12, 2017 Published: February 24, 2017
Accurate gross classification through imaging is critical for determination of hepatocellular carcinoma (HCC) patient prognoses and treatment strategies. The present retrospective study evaluated the utility of contrast-enhanced computed tomography (CE-CT) combined with gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) for diagnosis and classification of HCCs prior to surgery. Ninety-four surgically resected HCC nodules were classified as simple nodular (SN), SN with extranodular growth (SN-EG), confluent multinodular (CMN), or infiltrative (IF) types. SN-EG, CMN and IF samples were grouped as non-SN. The abilities of the two imaging modalities to differentiate non-SN from SN HCCs were assessed using the EOB-MRI hepatobiliary phase and CE-CT arterial, portal, and equilibrium phases. Areas under the ROC curves for non-SN diagnoses were 0.765 (95% confidence interval [CI]: 0.666–0.846) for CE-CT, 0.877 (95% CI: 0.793–0.936) for EOB-MRI, and 0.908 (95% CI: 0.830–0.958) for CE-CT plus EOB-MRI. Sensitivities, specificities, and accuracies with respect to identification of non-SN tumors of all sizes were 71.4%, 81.6%, and 75.5% for CE-CT; 96.4%, 78.9%, and 89.3% for EOB-MRI; and 98.2%, 84.2%, and 92.5% for CE-CT plus EOB-MRI. These results show that CE-CT combined with EOB-MRI offers a more accurate imaging evaluation for HCC gross classification than either modality alone.
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