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Measuring HCC Tumor Size in MRI-The Sequence Matters!

Marco Armbruster1, Markus Guba2, Joachim Andrassy2

  • 1Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany.

Diagnostics (Basel, Switzerland)
|November 27, 2021
PubMed
Summary
This summary is machine-generated.

Magnetic resonance imaging (MRI) accurately measures hepatocellular carcinoma (HCC) lesion sizes. The hepatobiliary phase T1-weighted sequence offers the best accuracy for HCC tumor measurement, reducing misclassification rates according to Milan criteria.

Keywords:
MRIhepatobiliary agentshepatobiliary phasehepatocellular carcinomaliver transplantation

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Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Hepatocellular carcinoma (HCC) is a primary liver cancer.
  • Accurate tumor size measurement is crucial for treatment decisions, especially regarding Milan criteria.
  • Magnetic resonance imaging (MRI) is a key modality for HCC assessment.

Purpose of the Study:

  • To compare the accuracy of different MRI pulse sequences in measuring HCC lesion sizes.
  • To evaluate the impact of MRI measurements on Milan criteria classification.
  • To determine the optimal MRI sequence for HCC size assessment against histopathology.

Main Methods:

  • 45 patients with HCC underwent contrast-enhanced liver MRI.
  • Tumor size was assessed using various T1-weighted and T2-weighted MRI sequences.
  • MRI measurements were correlated with pathological findings using statistical analyses.
  • Misclassification rates based on Milan criteria were calculated for each sequence.

Main Results:

  • The hepatobiliary phase T1-weighted sequence showed the smallest mean absolute error (0.71 ± 0.70 cm) in size measurement compared to pathology (r = 0.96).
  • T2w half-Fourier acquisition single-shot turbo spin-echo and hepatobiliary phase T1w sequences had the lowest misclassification rates (8.6%) for Milan criteria.
  • T2w turbo-spin-echo and portal venous phase T1w sequences exhibited higher misclassification rates (14.3%).

Conclusions:

  • Hepatobiliary phase T1-weighted MRI is the most accurate sequence for measuring HCC tumor size.
  • This sequence minimizes misclassification rates concerning the Milan criteria.
  • Accurate MRI measurements are vital for effective HCC management and treatment planning.