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The utility of diffusion-weighted imaging in improving the sensitivity of LI-RADS classification of small hepatic observations suspected of malignancy.
Basha, Mohammad Abd Alkhalik; Refaat, Rania; Mohammad, Faten Fawzy; Khamis, Mai E M; El-Maghraby, Ahmed Mohamed; El Sammak, Ahmed A; Al-Molla, Rania M; Mohamed, Heba A E; Alnaggar, Ahmad Abdullah; Hassan, Hanan Abdelhameed; Azmy, Taghreed M; Alaa Eldin, Ahmed M; Assy, Mostafa Mohamad; AlAzzazy, Mohamad Zakarya; Altaher, Khaled Mohamed; Tantawy, Heba Fathy; Saber, Sameh; Amin, Mohamed I; Alsowey, Ahmed Mohamed; Radwan, Mohamed Hesham Saleh; Taha, Heba F; Fathy, Talaat; Hanafy, Amr Shaaban; Abdelbary, Eman H.
Afiliación
  • Basha MAA; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt. drmohammad_basha@yahoo.com.
  • Refaat R; Department of Radiodiagnosis, Ain Shams University, Cairo, Egypt.
  • Mohammad FF; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Khamis MEM; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • El-Maghraby AM; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • El Sammak AA; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Al-Molla RM; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Mohamed HAE; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Alnaggar AA; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Hassan HA; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Azmy TM; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Alaa Eldin AM; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Assy MM; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • AlAzzazy MZ; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Altaher KM; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Tantawy HF; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Saber S; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Amin MI; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Alsowey AM; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Radwan MHS; Department of Radiodiagnosis, Zagazig University, Zagazig, Egypt.
  • Taha HF; Department of Medical Oncology, Zagazig University, Zagazig, Egypt.
  • Fathy T; Department of Tropical Medicine, Zagazig University, Zagazig, Egypt.
  • Hanafy AS; Department of Internal MEDICINE, Hepatology Division, Zagazig University, Zagazig, Egypt.
  • Abdelbary EH; Department of Pathology, Zagazig University, Zagazig, Egypt.
Abdom Radiol (NY) ; 44(5): 1773-1784, 2019 05.
Article en En | MEDLINE | ID: mdl-30603882
PURPOSE: We investigated the added value of diffusion-weighted imaging (DWI)/apparent diffusion coefficient (ADC) in the categorization of small hepatic observation (≤ 20 mm) detected in patients with chronic liver disease in reference to LI-RADS (liver imaging reporting and data system) classification system. METHODS: We prospectively evaluated 165 patients with chronic liver disease with small hepatic observations (≤ 20 mm) which were previously categorized as LI-RADS grade 3-5 on dynamic contrast-enhanced CT (DCE-CT). All patients were submitted to a functional MRI including DCE and DWI. Using LI-RADS v2017, two radiologists independently evaluated the observations and assigned a LI-RADS category to each observation using DCE-MRI alone and combined DCE-MRI and DWI/ADC. In the combined technique, the radiologists assigned a LI-RADS category based on a modified LI-RADS criteria in which restricted diffusion on DWI was considered a major feature of HCC. We evaluated the inter-reader agreement with Kappa statistics and compared the diagnostic performance of the LI-RADS with two imaging techniques by Fisher's exact test using histopathology as the reference standard. RESULTS: Combined technique in LI-RADS yielded better sensitivities (reader 1, 97% [65/67]; reader 2, 95.5% [64/67]) for HCC diagnosis than DCE-MRI alone (reader 1, 80.6% [54/67], p = 0.005; reader 2, 83.6% [56/67], p = 0.04). The specificities were insignificantly lower in combined technique (reader 1, 88.4% [107/121]; reader 2, 77.7% [94/121]) than in DCE-MRI alone (reader 1, 90.9% [110/121], p = 0.67; reader 2, 79.3% [96/121], p = 0.88). The inter-reader agreement of the LI-RADS scores between combined technique and DCE-MRI was good (κ = 0.765). CONCLUSION: The use of DWI/ADC as an additional major criterion, improved the sensitivity of LI-RADS in the diagnosis of HCC while keeping high specificity.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen de Difusión por Resonancia Magnética / Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies / Observational_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Abdom Radiol (NY) Año: 2019 Tipo del documento: Article País de afiliación: Egipto Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen de Difusión por Resonancia Magnética / Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies / Observational_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Abdom Radiol (NY) Año: 2019 Tipo del documento: Article País de afiliación: Egipto Pais de publicación: Estados Unidos