Author(s): Akai H, Matsuda I, Kiryu S, Tajima T, Takao H,
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Abstract PURPOSE: To investigate the natural outcome and clinical implication of hypointense lesions in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI. MATERIALS AND METHODS: Forty patients underwent Gd-EOB-DTPA-enhanced MRI for preoperative evaluation of HCC. Hypointense lesions in the hepatobiliary phase that were hypovascular 5mm of more were extracted for follow-up. We performed a longitudinal study retrospectively for these lesions regardless of whether classical HCC developed or emerged in a different area from that of the lesions being followed. RESULTS: Thirty one patients displayed 130 hypointense lesions on MRI and only nine showed no hypointense lesions. In total, 17 (13.1\%) of 130 hypointense lesions on MRI developed into classical HCC. The cumulative rates for these lesions to develop into classical HCC were 3.2\% at 1 year, 11.1\% at 2 years and 15.9\% at 3 years. The total occurrence rates of classical HCC (25.8\% at 1 year, 52.6\% at 2 years and 76.4\% at 3 years) were higher compared to those regarding only occurrence of classical HCC from hypointense lesions on MRI (10.0\% at 1 year, 35.6\% at 2 years and 44.6\% at 3 years), although no significant difference was observed (p=0.073). CONCLUSIONS: Hypointense lesions that are detected in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI have some malignant potential, although treating these lesions aggressively in patients who already have HCC may be too severe. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
This article was published in Eur J Radiol
and referenced in Journal of Liver