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Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort
The value of gadoxetic acid in the diagnosis of hepatocellular carcinoma (HCC), based on perfusion criteria, is under dispute. This post-hoc analysis of the prospective, phase II, randomized, controlled SORAMIC study compared the accuracy of gadoxetic acid-enhanced dynamic magnetic resonance imaging...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870455/ https://www.ncbi.nlm.nih.gov/pubmed/35200551 http://dx.doi.org/10.3390/curroncol29020051 |
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author | Seidensticker, Max Steffen, Ingo G. Bargellini, Irene Berg, Thomas Benito, Alberto Gebauer, Bernhard Iezzi, Roberto Loewe, Christian Karçaaltincaba, Musturay Pech, Maciej Sengel, Christian van Delden, Otto Vandecaveye, Vincent Zech, Christoph J. Ricke, Jens |
author_facet | Seidensticker, Max Steffen, Ingo G. Bargellini, Irene Berg, Thomas Benito, Alberto Gebauer, Bernhard Iezzi, Roberto Loewe, Christian Karçaaltincaba, Musturay Pech, Maciej Sengel, Christian van Delden, Otto Vandecaveye, Vincent Zech, Christoph J. Ricke, Jens |
author_sort | Seidensticker, Max |
collection | PubMed |
description | The value of gadoxetic acid in the diagnosis of hepatocellular carcinoma (HCC), based on perfusion criteria, is under dispute. This post-hoc analysis of the prospective, phase II, randomized, controlled SORAMIC study compared the accuracy of gadoxetic acid-enhanced dynamic magnetic resonance imaging (MRI) (arterial, portovenous, and venous phase only) versus contrast-enhanced computed tomography (CT) for stratifying patients with HCC to curative ablation or palliative treatment. Two reader groups (radiologists, R1 and R2) performed blind reads of CT and gadoxetic acid-enhanced MRI (contrast dynamics only). A truth panel, with access to clinical and imaging follow-up data, served as reference. Primary endpoint was non-inferiority (margin: 5% points) of MRI vs. CT (lower 95% confidence interval [CI] > 0.75) in a first step and superiority (complete 95% CI > 1) in a second step. The intent-to-treat population comprised 538 patients. Accuracy of treatment decisions was 73.4% and 70.8% for CT (R1 and R2, respectively) and 75.1% and 70.3% for gadoxetic acid-enhanced dynamic MRI. Non-inferiority but not superiority of gadoxetic acid-enhanced dynamic MRI versus CT was demonstrated (odds ratio 1.01; CI 0.97–1.05). Despite a theoretical disadvantage in wash-out depiction, gadoxetic acid-enhanced dynamic MRI is non-inferior to CT in accuracy of treatment decisions for curative ablation versus palliative strategies. This outcome was not subject to the use of additional MR standard sequences. |
format | Online Article Text |
id | pubmed-8870455 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-88704552022-02-25 Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort Seidensticker, Max Steffen, Ingo G. Bargellini, Irene Berg, Thomas Benito, Alberto Gebauer, Bernhard Iezzi, Roberto Loewe, Christian Karçaaltincaba, Musturay Pech, Maciej Sengel, Christian van Delden, Otto Vandecaveye, Vincent Zech, Christoph J. Ricke, Jens Curr Oncol Article The value of gadoxetic acid in the diagnosis of hepatocellular carcinoma (HCC), based on perfusion criteria, is under dispute. This post-hoc analysis of the prospective, phase II, randomized, controlled SORAMIC study compared the accuracy of gadoxetic acid-enhanced dynamic magnetic resonance imaging (MRI) (arterial, portovenous, and venous phase only) versus contrast-enhanced computed tomography (CT) for stratifying patients with HCC to curative ablation or palliative treatment. Two reader groups (radiologists, R1 and R2) performed blind reads of CT and gadoxetic acid-enhanced MRI (contrast dynamics only). A truth panel, with access to clinical and imaging follow-up data, served as reference. Primary endpoint was non-inferiority (margin: 5% points) of MRI vs. CT (lower 95% confidence interval [CI] > 0.75) in a first step and superiority (complete 95% CI > 1) in a second step. The intent-to-treat population comprised 538 patients. Accuracy of treatment decisions was 73.4% and 70.8% for CT (R1 and R2, respectively) and 75.1% and 70.3% for gadoxetic acid-enhanced dynamic MRI. Non-inferiority but not superiority of gadoxetic acid-enhanced dynamic MRI versus CT was demonstrated (odds ratio 1.01; CI 0.97–1.05). Despite a theoretical disadvantage in wash-out depiction, gadoxetic acid-enhanced dynamic MRI is non-inferior to CT in accuracy of treatment decisions for curative ablation versus palliative strategies. This outcome was not subject to the use of additional MR standard sequences. MDPI 2022-01-27 /pmc/articles/PMC8870455/ /pubmed/35200551 http://dx.doi.org/10.3390/curroncol29020051 Text en © 2022 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 Seidensticker, Max Steffen, Ingo G. Bargellini, Irene Berg, Thomas Benito, Alberto Gebauer, Bernhard Iezzi, Roberto Loewe, Christian Karçaaltincaba, Musturay Pech, Maciej Sengel, Christian van Delden, Otto Vandecaveye, Vincent Zech, Christoph J. Ricke, Jens Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort |
title | Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort |
title_full | Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort |
title_fullStr | Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort |
title_full_unstemmed | Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort |
title_short | Gadoxetic Acid-Based MRI for Decision-Making in Hepatocellular Carcinoma Employing Perfusion Criteria Only—A Post Hoc Analysis from the SORAMIC Trial Diagnostic Cohort |
title_sort | gadoxetic acid-based mri for decision-making in hepatocellular carcinoma employing perfusion criteria only—a post hoc analysis from the soramic trial diagnostic cohort |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870455/ https://www.ncbi.nlm.nih.gov/pubmed/35200551 http://dx.doi.org/10.3390/curroncol29020051 |
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