Detection of hepatocellular carcinoma: comparison of low- and high-spatial-resolution dynamic MR images

The purpose of our study was to compare the diagnostic performance of low- and high-spatial-resolution gadolinium chelate-enhanced triphasic dynamic gradient-recalled echo (GRE) MR images in the detection of hepatocellular carcinoma.

Triphasic dynamic MR images obtained with low (256 x 128) and high (512 x 224) image matrices in 28 patients with 65 hepatocellular carcinomas (HCCs) were retrospectively analyzed. Image review was conducted on a segment-by-segment basis; a total of 215 liver segments, including 56 segments with tumor burden, were reviewed for the presence of HCC by three independent radiologists. Detectability was evaluated with relative sensitivity, specificity, and receiver operating characteristic (ROC) analysis. Image quality was evaluated with rank order analysis.

Relative sensitivity was statistically significantly better with high-spatial-resolution images than with low-spatial-resolution images (p < .005). Relative specificity was statistically significantly better with low-spatial-resolution images than with high-spatial-resolution images (p < .001). Diagnostic accuracy determined by ROC curve analysis was marginally higher with high-spatial-resolution (area under ROC curve [Az] = .97) than with low-spatial-resolution (Az = .94, p < .09) images. Image quality was statistically significantly better with high-spatial-resolution images (p < .005).

High-spatial-resolution dynamic GRE images were superior to low-spatial-resolution images in sensitivity of detecting HCC and in image quality. Triphasic dynamic GRE imaging in the screening and follow-up programs of patients with suspected HCC should be performed using high image matrices.