CT versus MR imaging of hepatocellular carcinoma: toward improved treatment decisions

Detection, characterization, staging, and treatment monitoring are major roles of diagnostic imaging of liver cancers. Developments in multidetector-row computed tomography (MDCT) technology have increased the spatial and temporal resolution of CT to allow more precise evaluation of the hemodynamics of liver tumors and improve the diagnostic accuracy of dynamic MDCT. The high spatial and temporal resolutions of dynamic MDCT enable us to reconstruct 3-dimensional (3D) images that are very useful for pretreatment evaluation. Dynamic MR imaging with fast 3D T(1)-weighted gradient echo imaging sequence using nonspecific contrast medium can be highly sensitive for detecting hypervascular HCC. However, the use of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA), a contrast medium specific to hepatic tissue, offers greater diagnostic ability and, so, has become essential to liver imaging. MR imaging with Gd-EOB-DTPA may replace CT during hepatic arteriography and CT during arterioportography.