Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients

Vincenza Granata, Roberta Grassi, Roberta Fusco, Sergio Venanzio Setola, Andrea Belli, Mauro Piccirillo, Silvia Pradella, Marzia Giordano, Salvatore Cappabianca, Luca Brunese, Roberto Grassi, Antonella Petrillo and Francesco Izzo
Additional contact information
Vincenza Granata: Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy
Roberta Grassi: Division of Radiology, University of Campania Luigi Vanvitelli, 80127 Naples, Italy
Roberta Fusco: Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy
Sergio Venanzio Setola: Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy
Andrea Belli: Hepatobiliary Surgical Oncology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy
Mauro Piccirillo: Hepatobiliary Surgical Oncology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy
Silvia Pradella: Division of Radiology, “Azienda Ospedaliera Universitaria Careggi”, 50139 Florence, Italy
Marzia Giordano: Division of Radiology, University of Campania Luigi Vanvitelli, 80127 Naples, Italy
Salvatore Cappabianca: Division of Radiology, University of Campania Luigi Vanvitelli, 80127 Naples, Italy
Luca Brunese: Radiology Division, Università degli Studi del Molise, Via Francesco De Sanctis, 86100 Campobasso, Italy
Roberto Grassi: Division of Radiology, University of Campania Luigi Vanvitelli, 80127 Naples, Italy
Antonella Petrillo: Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy
Francesco Izzo: Hepatobiliary Surgical Oncology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy

IJERPH, 2021, vol. 18, issue 7, 1-14

Abstract: Background: Liver Imaging Reporting and Data Systems (LI-RADS) Treatment Response Algorithm (TRA) was created to provide a standardized assessment of hepatocellular carcinoma (HCC) following loco regional therapy. The aim of this study was to compare sensitivity of standard MRI protocol versus abbreviated protocol (only T1-Weigthed fat suppressed (FS) sequences pre- and post-contrast phase) in the detection of ablated area according to LI-RADS Treatment Response (LR-TR) categories. Methods: From January 2015 to June 2020, we selected 64 patients with HCC, who underwent Radiofrequency ablation (RFA) or Microwave ablation (MWA) treatment. According to inclusion criteria, 136 pathologically proven treated HCC (median 2, range 1–3 per patient; mean size 20.0 mm; range 15–30 mm) in 58 patients (26 women, 32 men; median age, 74 years; range, 62–83 years) comprised our study population. For each ablated area, abbreviated protocol, and standard Magnetic Resonance Imaging (MRI) studies were independently and blindly assessed in random order within and between three expert radiologists. Each radiologist assessed the ablated area by using the following categories: “LR-TR Non-viable” = 1; “LR-TR Equivocal” = 2 and “LR-TR Viable” = 0. Results: According to the concordance between MRI and Contrast enhancement ultrasound (CEUS) among 136 treated HCCs, 115 lesions were assessed as non-viable or totally ablate and 21 as viable or partially ablate. The accuracy for standard MRI protocol and abbreviated MRI protocol for predicting pathologic tumor viability of a consensus reading was 98.6% (sensitivity = 100%; specificity = 98.3%; positive predictive value = 91.3% and negative predictive value = 100%). No differences were found in sensitivity or specificity between standard MRI LR-TR viable and abbreviated MRI LR-TR viable categories ( p value > 0.05 at McNemar test). Conclusion: The abbreviated dynamic protocol showed similar diagnostic accuracy to conventional MRI study in the assessment of treated HCCs, with a reduction of the acquisition study time of 30% respect to conventional MRI.

Keywords: HCC; ablation treatment; magnetic resonance imaging; DWI; contrast enhancement MRI (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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