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Evolution of indeterminate hepatocellular nodules at Gd-EOB-DPTA-enhanced MRI in cirrhotic patients

Massimo Galia1, Francesco Agnello2, Gianvincenzo Sparacia1

  • 1Department of Radiology, University of Palermo, Via XII Gennaio 1/g, 90141, Palermo, Italy.

La Radiologia Medica
|March 17, 2018
PubMed

Insights

Indeterminate nodules in cirrhotic patients rarely progress to hepatocellular carcinoma (HCC). Key predictors of HCC development include nodule size increase and hepatobiliary phase hypointensity on MRI.

Area of Science:

  • Hepatology
  • Radiology
  • Oncology

Background:

  • Cirrhosis increases hepatocellular carcinoma (HCC) risk.
  • Indeterminate nodules on MRI require careful monitoring.
  • Gadolinium-ethoxybenzyl-diethylenetriamine-pentacetic acid (Gd-EOB-DTPA)-enhanced MRI aids nodule characterization.

Purpose of the Study:

  • To analyze the evolution of indeterminate hepatocellular nodules in cirrhotic patients.
  • To identify predictors of HCC development using serial Gd-EOB-DTPA-enhanced MRI.

Main Methods:

  • Retrospective analysis of 69 indeterminate nodules in 33 cirrhotic patients.
  • Follow-up MRI for at least 2 years.
  • Evaluation of nodule size, signal intensity, and clinical factors.

Main Results:

  • Only 5/69 nodules progressed to HCC.
  • Nodule size increase and hepatobiliary phase hypointensity were significant predictors of HCC development.
  • HCC history was more frequent in nodules that became HCCs.

Conclusions:

  • Indeterminate hepatocellular nodules in cirrhotic patients rarely develop into HCC.
  • Hepatobiliary phase hypointensity shows a weak association with HCC development.
  • Serial MRI is crucial for monitoring nodule changes.
Abstract

Keywords:
CirrhosisGd-EOB-DTPAHCCIndeterminate hepatocellular noduleLiver MRI

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