Measuring HCC Tumor Size in MRI—The Sequence Matters!

Background: The aim of this paper was to assess and compare the accuracy of common magnetic resonance imaging (MRI) pulse sequences in measuring the lesion sizes of hepatocellular carcinomas (HCCs) with respect to the Milan criteria and histopathology as a standard of reference. Methods: We included...

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Autores principales:	Marco Armbruster, Markus Guba, Joachim Andrassy, Markus Rentsch, Vincent Schwarze, Johannes Rübenthaler, Thomas Knösel, Jens Ricke, Harald Kramer
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	hepatocellular carcinoma liver transplantation MRI hepatobiliary agents hepatobiliary phase Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/b1da7848677947b7a55ba978445648ff
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spelling	oai:doaj.org-article:b1da7848677947b7a55ba978445648ff2021-11-25T17:20:38ZMeasuring HCC Tumor Size in MRI—The Sequence Matters!10.3390/diagnostics111120022075-4418https://doaj.org/article/b1da7848677947b7a55ba978445648ff2021-10-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2002https://doaj.org/toc/2075-4418Background: The aim of this paper was to assess and compare the accuracy of common magnetic resonance imaging (MRI) pulse sequences in measuring the lesion sizes of hepatocellular carcinomas (HCCs) with respect to the Milan criteria and histopathology as a standard of reference. Methods: We included 45 patients with known HCC who underwent contrast-enhanced MRI of the liver prior to liver transplantation or tumor resection. Tumor size was assessed pathologically for all patients. The MRI protocol contained axial T2-weighted images as well as T1-weighted imaging sequences before and after application of Gd-EOB-DTPA. Tumor diameters, the sharpness of lesions, and the presence of artifacts were evaluated visually on all available MRI sequences. MRI measurements and pathologically assessed tumor dimensions were correlated using Pearson’s correlation coefficient and Bland–Altman plots. The rate of misclassifications following Milan criteria was assessed. Results: The mean absolute error (in cm) of MRI size measurements in comparison to pathology was the smallest for the hepatobiliary phase T1-weighted acquisition (0.71 ± 0.70 cm, r = 0.96) and largest for the T2w turbo-spin-echo (TSE) sequence (0.85 ± 0.78 cm, r = 0.94). The misclassification rate regarding tumor size under the Milan criteria was lowest for the T2w half-Fourier acquisition single-shot turbo spin-echo sequence and the hepatobiliary phase T1w acquisition (each 8.6%). The highest rate of misclassification occurred in the portal venous phase T1w acquisition and T2w TSE sequence (each 14.3%). Conclusions: The hepatobiliary phase T1-weighted acquisition seems to be most accurate among commonly used MRI sequences for measuring HCC tumor size, resulting in low rates of misclassification with respect to the Milan criteria.Marco ArmbrusterMarkus GubaJoachim AndrassyMarkus RentschVincent SchwarzeJohannes RübenthalerThomas KnöselJens RickeHarald KramerMDPI AGarticlehepatocellular carcinomaliver transplantationMRIhepatobiliary agentshepatobiliary phaseMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2002, p 2002 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hepatocellular carcinoma liver transplantation MRI hepatobiliary agents hepatobiliary phase Medicine (General) R5-920
spellingShingle	hepatocellular carcinoma liver transplantation MRI hepatobiliary agents hepatobiliary phase Medicine (General) R5-920 Marco Armbruster Markus Guba Joachim Andrassy Markus Rentsch Vincent Schwarze Johannes Rübenthaler Thomas Knösel Jens Ricke Harald Kramer Measuring HCC Tumor Size in MRI—The Sequence Matters!
description	Background: The aim of this paper was to assess and compare the accuracy of common magnetic resonance imaging (MRI) pulse sequences in measuring the lesion sizes of hepatocellular carcinomas (HCCs) with respect to the Milan criteria and histopathology as a standard of reference. Methods: We included 45 patients with known HCC who underwent contrast-enhanced MRI of the liver prior to liver transplantation or tumor resection. Tumor size was assessed pathologically for all patients. The MRI protocol contained axial T2-weighted images as well as T1-weighted imaging sequences before and after application of Gd-EOB-DTPA. Tumor diameters, the sharpness of lesions, and the presence of artifacts were evaluated visually on all available MRI sequences. MRI measurements and pathologically assessed tumor dimensions were correlated using Pearson’s correlation coefficient and Bland–Altman plots. The rate of misclassifications following Milan criteria was assessed. Results: The mean absolute error (in cm) of MRI size measurements in comparison to pathology was the smallest for the hepatobiliary phase T1-weighted acquisition (0.71 ± 0.70 cm, r = 0.96) and largest for the T2w turbo-spin-echo (TSE) sequence (0.85 ± 0.78 cm, r = 0.94). The misclassification rate regarding tumor size under the Milan criteria was lowest for the T2w half-Fourier acquisition single-shot turbo spin-echo sequence and the hepatobiliary phase T1w acquisition (each 8.6%). The highest rate of misclassification occurred in the portal venous phase T1w acquisition and T2w TSE sequence (each 14.3%). Conclusions: The hepatobiliary phase T1-weighted acquisition seems to be most accurate among commonly used MRI sequences for measuring HCC tumor size, resulting in low rates of misclassification with respect to the Milan criteria.
format	article
author	Marco Armbruster Markus Guba Joachim Andrassy Markus Rentsch Vincent Schwarze Johannes Rübenthaler Thomas Knösel Jens Ricke Harald Kramer
author_facet	Marco Armbruster Markus Guba Joachim Andrassy Markus Rentsch Vincent Schwarze Johannes Rübenthaler Thomas Knösel Jens Ricke Harald Kramer
author_sort	Marco Armbruster
title	Measuring HCC Tumor Size in MRI—The Sequence Matters!
title_short	Measuring HCC Tumor Size in MRI—The Sequence Matters!
title_full	Measuring HCC Tumor Size in MRI—The Sequence Matters!
title_fullStr	Measuring HCC Tumor Size in MRI—The Sequence Matters!
title_full_unstemmed	Measuring HCC Tumor Size in MRI—The Sequence Matters!
title_sort	measuring hcc tumor size in mri—the sequence matters!
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/b1da7848677947b7a55ba978445648ff
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Measuring HCC Tumor Size in MRI—The Sequence Matters!

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