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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: PURPOSE, MATERIALS, RESULTS. Meshes: Adult, Aged, Carcinoma, Hepatocellular, Confidence Intervals, Contrast Media, Female, Ferrosoferric Oxide, Gadolinium DTPA, Humans, Liver Neoplasms, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, ROC Curve, Radionuclide Imaging, Sensitivity and Specificity, Tomography, X-Ray Computed.
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Detection of small hepatocellular carcinoma: can gadoxetic acid-enhanced magnetic resonance imaging replace combining gadopentetate dimeglumine-enhanced and superparamagnetic iron oxide-enhanced magnetic resonance imaging? Context: To investigate whether gadoxetic acid-enhanced magnetic resonance imaging (MRI) has the diagnostic capability and sensitivity comparable to the combination of gadopentetate dimeglumine-enhanced MRI and superparamagnetic iron oxide-enhanced MRI (double-contrast MRI) in the detection of small hepatocellular carcinomas (HCCs). Forty-one patients with 56 HCCs (size range, 0.5-2.0 cm) who underwent gadoxetic acid-enhanced MRI and double-contrast MRI with a mean interval of 4 days (range, 3-9 days) were included in this study. HCCs were diagnosed by histology (n = 25) and imaging findings (n = 31). Two observers independently reviewed the gadoxetic acid set (unenhanced, early dynamic, and hepatocyte phase images) and the double-contrast MRI set, at an initial reading session, and then reached consensus. Diagnostic accuracy and sensitivity were evaluated using the alternative-free response receiver operator characteristic method. Diagnostic accuracy (AZ) and sensitivity were similar for both image sets (0.955, 83.9% for gadoxetic acid set; 0.952, 80.4% for double-contrast MRI set) (P>0.05). There were 5 and 3 HCCs that were verified only on the gadoxetic acid set and double-contrast MRI set, respectively. All 9 HCCs that were not verified on the gadoxetic acid set were assigned a low confidence rating of 1 or 2. However, 3 of the 11 HCCs, which were not verified on double-contrast MRI, were not seen even upon retrospective review.
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Gadoxetic acid-enhanced MRI can replace double-contrast MRI for the detection of HCCs. Because all HCCs were delineated on gadoxetic acid-enhanced MRI, even with a low confidence rating, and 3 HCCs were not seen on double-contrast MRI, gadoxetic acid-enhanced MRI could be more advantageous than double-contrast MRI for HCC work-up.