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Improved diagnosis of histological capsule in hepatocallular carcinoma by using nonenhancing capsule appearance in addition to enhancing capsule appearance in gadoxetic acid-enhanced MRI

Nishioka, Eiko Sofue, Keitaro Maruyama, Koji Ueshima, Eisuke Ueno, Yoshiko Tsurusaki, Masakatsu Komatsu, Shohei Fukumoto, Takumi Murakami, Takamichi 神戸大学

2023.04.14

概要

To assess the value of nonenhancing capsule by adding to enhancing capsule in gadoxetic acid-enhanced MRI (EOB-MRI) in comparison with contrast-enhanced CT (CE-CT) for diagnosing histological capsule in hepatocellular carcinoma (HCC). One-hundred fifty-one patients with HCC who underwent both CE-CT and EOB-MRI were retrospectively reviewed. Liver Imaging-Reporting and Data System (LI-RADS) v2018 imaging features, including enhancing and nonenhancing capsule were evaluated by two readers in CE-CT and EOB-MRI. Frequencies of each imaging feature were compared between CE-CT and EOB-MRI. The area under the receiver operating characteristic (AUC) curve for the diagnosis of histological capsule was compared across the following three imaging criteria: (1) enhancing capsule in CE-CT, (2) enhancing capsule in EOB-MRI, and (3) enhancing/nonenhancing capsule in EOB-MRI. Enhancing capsule in EOB-MRI was significantly less frequently depicted than that in CE-CT (p < 0.001 and = 0.016 for reader 1 and 2). Enhancing/nonenhancing capsule in EOB-MRI achieved a similar frequency of enhancing in CE-CT (p = 0.590 and 0.465 for reader 1 and 2). Adding nonenhancing capsule to enhancing capsule in EOB-MRI significantly increased AUCs (p < 0.001 for both readers) and achieved similar AUCs compared with enhancing capsule in CE-CT (p = 0.470 and 0.666 for reader 1 and 2). Adding nonenhancing capsule to the definition of capsule appearance can improve the diagnosis of capsule in EOB-MRI for the diagnosis of histological capsule in HCC and decrease discordance of capsule appearance between EOB-MRI and CE-CT.

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Author contributions

K.S. initiated the study; made substantial contributions to the conception and design of the work, and analysis of

the data. K.S., K.M., E.U., S.K., Y.U., and M.T. made substantial contributions to the acquisition of the data. E.N.

wrote the draft of the manuscript. K.S., E.U., M.T., T.F., and T.M. critically revised the manuscript for important

intellectual content. All authors have agreed to be accountable for all aspects of the work.

Competing interests The authors declare no competing interests.

Additional information

Correspondence and requests for materials should be addressed to K.S.

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