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AIM:To compare the diagnostic capability of multidetector computed tomography(MDCT) and magnetic resonance imaging(MRI) for the detection of hepatocellular carcinoma(HCC) tumour nodules and their effect on patient management.METHODS:A total of 28 patients(25 male,3 female,mean age 67±10.8 years) with biopsy-proven HCC were investigated with 64-row MDCT(slice 3 mm native,arterial and portal-venous phase,120 mL Iomeprol,4 mL/s,delay by bolus trigger) and MRI(T1fs fl2d TE/ TR 2.72/129 ms,T2tse TE/TR 102/4000 ms,5-phase dynamic contrast-enhanced T1fs fl3d TE/TR 1.56/4.6,Gadolinium-DTPA,slice 4 mm).Consensus reading of both modalities was used as reference.Tumour nodules were analyzed with respect to number,size,and location.RESULTS:In total,162 tumour nodules were detected by consensus reading.MRI detected signifi cantly more tumour nodules(159 vs 123,P<0.001) compared to MDCT,with the best sensitivity for early arterial phase MRI.False-negative CT findings included nodules ≤5 mm(n=5),≤10 mm(n=17),≤15 mm(n=12),≤20 mm(n=4),and 1 nodule >20 mm.MRI missed 2 nodules ≤10 mm and 1 nodule ≤15 mm.On MRI,nodule diameters were greater than on CT(29.2±25.1 mm,range 5-140 mm vs 24.1±22.7 mm,range 4-129 mm,P<0.005).In 2 patients,MDCT showed only unilobar tumour spread,whereas MRI revealed additional nodules in the contralateral lobe.Detection of these nodules could have changed the therapeutic strategy.CONCLUSION:Contrast-enhanced MRI is superior to 64-row MDCT for the detection of HCC nodules.Patients should be allocated to interventional or operative treatment according to a dedicated MRI-protocol.
AIM: To compare the diagnostic capability of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) for the detection of hepatocellular carcinoma (HCC) tumor nodules and their effect on patient management. METHODS: A total of 28 patients (25 male, 3 female, mean age 67 ± 10.8 years) with biopsy-proven HCC were investigated with 64-row MDCT (slice 3 mm native, arterial and portal-venous phase, 120 mL Iomeprol, 4 mL / s, delay by bolus trigger) and MRI (T1fs fl2d TE / TR 2.72 / 129 ms, T2tse TE / TR 102/4000 ms, 5-phase dynamic contrast-enhanced T1fs fl3d TE / TR 1.56 / 4.6, Gadolinium-DTPA, modalities was used as reference.Tumor nodules were analyzed with respect to number, size, and location .RESULTS: In total, 162 tumor nodules were detected by consensus reading. MRI detected signifi cantly more nodules (159 vs 123, P <0.001) compared to MDCT, with the best sensitivity for early arterial phase MRI. False-negative CT findings included nodules ≤ 5 mm (n = 5), 10 mm (n = 17), ≤ 15 mm (n = 12), ≤ 20 mm (n = 4), and 1 nodule> 20 mm. MRI missed 2 nodules ≤ 10 mm and 1 nodule ≤ 15 mm. nodule diameters were greater than on CT (29.2 ± 25.1 mm, range 5-140 mm vs 24.1 ± 22.7 mm, range 4-129 mm, P <0.005) .In 2 patients, MDCT showed only unilobal tumor spread, but MRI revealed additional nodules in the contralateral lobe. Detection of these nodules could have changed the therapeutic strategy. CONCLUSION: Contrast-enhanced MRI is superior to 64-row MDCT for the detection of HCC nodules. Patients should be allocated to interventional or operative treatment according to a dedicated MRI-protocol.