Gadoxetic Acid-enhanced MRI Versus MDCT For The Preoperative Detection Of Early-stage Hepatocellular Carcinoma Toward Stage And Tumour Capsule

Objective:This study is designed to evaluate the differences in BCLC stage and tumour capsule between dynamic CT and adding gadoxetic acid-enhanced dynamic MRI for early-stage HCC to investigate whether gadoxetic acid-enhanced dynamic MRI improves diagnostic performance.Methods:We performed a retrospective study of data from 73 patients diagnosed with early-stage HCC by initial dynamic CT who underwent simultaneously gadoxetic acid-enhanced dynamic MRI at our institution from January 2014 through December 2015.We compared the differences in BCLC stage and tumour capsule between dynamic CT and adding gadoxetic acid-enhanced dynamic MRI with McNemar test.Results:In 73 patients,Final stage was classified as stage 0 in 8 patients,A in 56 patients,B in 6 patients,C in 3 patients.Compared with dynamic CT,gadoxetic acid-enhanced dynamic MRI showed significantly greater sensitivity(94.8%[91/96]vs 81.3%[78/96];P<0.05)for HCC and significantly more accurate BCLC staging(91.7%[64/73]vs 69.9%[51/73];P<0.001)in early-stage HCC.For identifying tumour capsule,gadoxetic acid-enhanced dynamic MRI showed significantly sensitivity and accuracy(85%vs 50%and 86.3%vs 70.6%,respectively;P<0.05).After additional Gd-EOB-DTPA-enhanced MRI,BC LC stage was changed correctly in 24.7%(18/73)of the patients and tumour capsule was detected accurately in 13.7%(7/51)of the surgery patients.Conclusion:Compared with dynamic CT,gadoxetic acid-enhanced dynamic MRI showed greater sensitivity in diagnosis of HCC and tumour capsule and significantly more accuracy in BCLC stage and capsule appearance.It plays an important role in decision making of HCC.