Staging Hepatocellular Carcinoma with Gadolinium EthoxybenzylDiethylenetriaminepentaacetic Acid -Enhanced Magnetic ResonanceImaging: A Comparison with Multi-Detector Row Computed Tomography

Aim: To explore if gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MRI provides more accurate information than multi-detector row computed tomography (MDCT) for staging hepatocellular carcinoma (HCC). Methods: We retrospectively investigated 112 patients with HCC who underwent MDCT and Gd-EOB-DTPA enhanced MRI within one month before treatment. Two experienced radiologists reviewed the size, number, and boundaries of the HCC lesions, portal invasion, and tumor metastasis on MDCT and MRI images in consensus. Then the performance of Gd-EOB-DTPA-enhanced MRI and MDCT on staging HCC lesions was compared through statistical analysis. The classification of the Barcelona Clinic Liver Cancer (BCLC) stage was also evaluated. Results: HCC lesions in five patients were detected on Gd-EOB-DTPA-enhanced MRI only. Of the other 107 patients, 21 (19.6%) were in BCLC stage 0, 49 (45.8%) in BCLC stage A, 14 (13.1%) in BCLC stage B, and 23 (21.5%) in BCLC stage C on MDCT. On Gd-EOB-DTPA-enhanced MRI, 12 (11.2%), 48 (44.9%), 17 (15.9%), and 30 (28.0%) patients were classified as BCLC stages 0, A, B, and C, respectively. The two methods differed significantly in staging HCC patients (χ2=16.444, P=0.006). Conclusion: This study suggests that Gd-EOB-DTPA-enhanced MRI provides more accurate information than MDCT for characterizing and staging HCC which will help to choose accurate treatment strategy.