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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: Armbruster, Marco, Guba, Markus, Andrassy, Joachim, Rentsch, Markus, Schwarze, Vincent, Rübenthaler, Johannes, Knösel, Thomas, Ricke, Jens, Kramer, Harald
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8623118/
https://www.ncbi.nlm.nih.gov/pubmed/34829348
http://dx.doi.org/10.3390/diagnostics11112002
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author Armbruster, Marco
Guba, Markus
Andrassy, Joachim
Rentsch, Markus
Schwarze, Vincent
Rübenthaler, Johannes
Knösel, Thomas
Ricke, Jens
Kramer, Harald
author_facet Armbruster, Marco
Guba, Markus
Andrassy, Joachim
Rentsch, Markus
Schwarze, Vincent
Rübenthaler, Johannes
Knösel, Thomas
Ricke, Jens
Kramer, Harald
author_sort Armbruster, Marco
collection PubMed
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.
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spelling pubmed-86231182021-11-27 Measuring HCC Tumor Size in MRI—The Sequence Matters! Armbruster, Marco Guba, Markus Andrassy, Joachim Rentsch, Markus Schwarze, Vincent Rübenthaler, Johannes Knösel, Thomas Ricke, Jens Kramer, Harald Diagnostics (Basel) Article 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. MDPI 2021-10-28 /pmc/articles/PMC8623118/ /pubmed/34829348 http://dx.doi.org/10.3390/diagnostics11112002 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Armbruster, Marco
Guba, Markus
Andrassy, Joachim
Rentsch, Markus
Schwarze, Vincent
Rübenthaler, Johannes
Knösel, Thomas
Ricke, Jens
Kramer, Harald
Measuring HCC Tumor Size in MRI—The Sequence Matters!
title 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_short Measuring HCC Tumor Size in MRI—The Sequence Matters!
title_sort measuring hcc tumor size in mri—the sequence matters!
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8623118/
https://www.ncbi.nlm.nih.gov/pubmed/34829348
http://dx.doi.org/10.3390/diagnostics11112002
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