Evaluation of an abbreviated screening MRI protocol for patients at risk for hepatocellular carcinoma

Jennifer Y. Lee, Eugene J. Huo, Stefanie Weinstein, Charmaine Santos, Alexander Monto, Carlos U. Corvera, Judy Yee, Thomas A. Hope

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: In this study, we compare an abbreviated screening MRI protocol (aMRI), utilizing only dynamic contrast-enhanced images, to a conventional liver MRI (cMRI) for the characterization of observations in at-risk patients. Materials and methods: 164 consecutive HCC screening MRIs were retrospectively analyzed. Two sets of de-identified image sets were created: one with all acquired sequences including T2- and diffusion-weighted sequences (cMRI), and one with only T1-weighted precontrast and dynamic post-contrast images utilizing an extracellular gadolinium contrast agent (aMRI). Three readers assigned a LI-RADS score based on the lesion with the highest LI-RADS category using the aMRI and cMRI datasets during separate reads. Results: There was no change between the aMRI and cMRI LI-RADS categorization in 93%, 96%, and 96% of cases for readers 1, 2, and 3, respectively. In the majority of the discrepant cases, the score increased from LI-RADS 3 to LI-RADS 4 due to the presence of ancillary features on T2 and DWI. Kappa values for interobserver variability demonstrated fair-to-moderate LI-RADS agreement among the 3 readers. Conclusion: There was strong agreement between the abbreviated T1-only MRI protocol and a full liver MRI, with only 5% of cases changing LI-RADS categorization due to the inclusion of T2 and DWI. The estimated time to run this abbreviated MRI is approximately 7–10 min, possibly allowing for a more cost-effective screening MRI than our cMRIs.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Oct 10 2017
Externally publishedYes

Fingerprint

Hepatocellular Carcinoma
Liver
Observer Variation
Gadolinium
Contrast Media
Costs and Cost Analysis

Keywords

  • Hepatocellular carcinoma
  • LI-RADS
  • MRI
  • Screening

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

Lee, J. Y., Huo, E. J., Weinstein, S., Santos, C., Monto, A., Corvera, C. U., ... Hope, T. A. (Accepted/In press). Evaluation of an abbreviated screening MRI protocol for patients at risk for hepatocellular carcinoma. Abdominal Radiology, 1-7. https://doi.org/10.1007/s00261-017-1339-5

Evaluation of an abbreviated screening MRI protocol for patients at risk for hepatocellular carcinoma. / Lee, Jennifer Y.; Huo, Eugene J.; Weinstein, Stefanie; Santos, Charmaine; Monto, Alexander; Corvera, Carlos U.; Yee, Judy; Hope, Thomas A.

In: Abdominal Radiology, 10.10.2017, p. 1-7.

Research output: Contribution to journalArticle

Lee, Jennifer Y. ; Huo, Eugene J. ; Weinstein, Stefanie ; Santos, Charmaine ; Monto, Alexander ; Corvera, Carlos U. ; Yee, Judy ; Hope, Thomas A. / Evaluation of an abbreviated screening MRI protocol for patients at risk for hepatocellular carcinoma. In: Abdominal Radiology. 2017 ; pp. 1-7.
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abstract = "Purpose: In this study, we compare an abbreviated screening MRI protocol (aMRI), utilizing only dynamic contrast-enhanced images, to a conventional liver MRI (cMRI) for the characterization of observations in at-risk patients. Materials and methods: 164 consecutive HCC screening MRIs were retrospectively analyzed. Two sets of de-identified image sets were created: one with all acquired sequences including T2- and diffusion-weighted sequences (cMRI), and one with only T1-weighted precontrast and dynamic post-contrast images utilizing an extracellular gadolinium contrast agent (aMRI). Three readers assigned a LI-RADS score based on the lesion with the highest LI-RADS category using the aMRI and cMRI datasets during separate reads. Results: There was no change between the aMRI and cMRI LI-RADS categorization in 93{\%}, 96{\%}, and 96{\%} of cases for readers 1, 2, and 3, respectively. In the majority of the discrepant cases, the score increased from LI-RADS 3 to LI-RADS 4 due to the presence of ancillary features on T2 and DWI. Kappa values for interobserver variability demonstrated fair-to-moderate LI-RADS agreement among the 3 readers. Conclusion: There was strong agreement between the abbreviated T1-only MRI protocol and a full liver MRI, with only 5{\%} of cases changing LI-RADS categorization due to the inclusion of T2 and DWI. The estimated time to run this abbreviated MRI is approximately 7–10 min, possibly allowing for a more cost-effective screening MRI than our cMRIs.",
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