Gadolinium-enhanced MRI for tumor surveillance before liver transplantation: center-based experience.

Gadolinium-enhanced MRI for tumor surveillance before liver transplantation: center-based experience. Research Abstract Details 

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Gadolinium-enhanced MRI for tumor surveillance before liver transplantation: center-based experience. Abstract Text:

Thomas C Lauenstein,Khalil Salman,Roger Morreira,Thomas Heffron,James R Spivey,Enrique Martinez,Puneet Sharma,Diego R Martin,

OBJECTIVE: The purpose of this study was to evaluate prospectively acquired institutional results to determine the accuracy of gadolinium-enhanced MRI in liver tumor surveillance before transplantation. SUBJECTS AND METHODS: One hundred fifteen patients underwent MRI of the abdomen within 90 days before liver transplantation. Images were acquired with gadolinium-enhanced 3D gradient-echo sequences in the arterial, venous, and delayed phases. Detection of hepatocellular carcinoma (HCC) was based on the imaging criteria arterial phase enhancement, delayed phase hypointensity, and development of an enhancing outer margin capsule. Imaging findings were compared with findings at histopathologic evaluation of the explanted liver. RESULTS: Thirty-six HCCs in 27 patients were detected at histopathologic evaluation. Patient-based analysis showed the sensitivity of MRI was 88.9% (24/27); specificity, 97.7% (false-positive findings in two patients); and accuracy, 95.7%. MRI depicted 28 of 36 HCCs, resulting in a lesion-based sensitivity of 77.8%. Although all 18 HCCs 2 cm or larger were depicted with MRI, only 10 of 18 HCCs smaller than 2 cm were correctly diagnosed. However, two HCCs measuring smaller than 2 cm at pathologic examination were rated as dysplastic nodules on MRI. CONCLUSION: Contrast-enhanced MRI can be used as a primary diagnostic method for accurate detection and characterization of HCC 2 cm or larger as required by the criteria of the Model for End-Stage Liver Disease used by the United Network for Organ Sharing. MRI can be considered a standard tool for surveillance before liver transplantation. Reduction in cost and risk may be derived from the diminished need for other diagnostic imaging studies and biopsy and the avoidance of use of iodinated contrast agents in imaging of patients with cirrhosis, many of whom have impaired renal function.

Gadolinium-enhanced MRI for tumor surveillance before liver transplantation: center-based experience. Publishing Authors By Initials

TC Lauenstein,K Salman,R Morreira,T Heffron,JR Spivey,E Martinez,P Sharma,DR Martin,

For similar surgical procedures, operative: transplantation research abstracts see: surgical procedures, operative: transplantation research

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Gadolinium-enhanced MRI for tumor surveillance before liver transplantation: center-based experience. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: AJR. American journal of roentgenology

VOLUME: 189

Page Numbers: 663-70

Journal Abbreviation:

ISSN: 1546-3141

DAY: 15

MONTH: Sep

YEAR: 2007

Gadolinium-enhanced MRI for tumor surveillance before liver transplantation: center-based experience. Information

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LANGUAGE: eng

NlmUniqueID: 7708173

Gadolinium-enhanced MRI for tumor surveillance before liver transplantation: center-based experience. Keywords Mesh Terms:

KEYWORDS: Transplantation

MESH TERMS: pathology

Chemical & Substance for Abstract: Gadolinium-enhanced MRI for tumor surveillance before liver transplantation: center-based experience. Information

Substance Name: Gadolinium

Registry Number: 7440-54-2

Grant and Affiliation Information for Gadolinium-enhanced MRI for tumor surveillance before liver transplantation: center-based experience.

AFFILIATION: Department of Radiology, Emory University Hospital, Emory Clinic, Bldg. A, Ste. AT-627, 1365 Clifton Rd., Atlanta, GA 30322, USA.

Country: United States

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MEDLINETA: AJR Am J Roentgenol

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