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Purpose <p>To compare the diagnostic performance of an abbreviated MRI (AMRI) protocol consisting of hepatobiliary phase (HBP) and T2-weighted sequences versus complete-protocol MRI, for secondary surveillance in patients with hepatocellular carcinoma (HCC) after microwave ablation (MWA).</p> Methods <p>This retrospective cohort study included 43 HCC patients who underwent MWA between 2017 and 2019, comprising 27 consecutive patients with recurrence and 16 randomly selected patients without recurrence (to increase the proportion of negative MRI exams presented to readers), resulting in a total of 215 complete-protocol gadoxetic acid-enhanced surveillance MRI exams. Three blinded radiologists independently reviewed AMRI exams, which consisted of only HBP and T2-weighted sequences for each surveillance MRI, with access to pre- and post-complete-protocol MRIs for comparison. Diagnostic performance of AMRI was compared with the results from complete MRI protocol.</p> Results <p>Inter-reader agreement was excellent (<i>κ</i> = 0.91). Overall diagnostic performance per-patient and per-AMRI was as follows: sensitivity (SEN), specificity (SPE), and negative predictive value (NPV) of 86.4% (95%CI: 77.3–92.2), 100% (95.5–100), and 88.1% (79.8–93.2) for per-patient, and 87.5% (81.1–91.9), 97.6% (95–98.9) and 93.3% (89.7–95.7) for per-AMRI. Per-patient evaluation in the nonlocal-R subcohort showed SEN, SPE, and NPV of 86.6% (75.8–93.1), 100% (84.5–100), and 72.4% (54.3–85.3), compared with 85.7% (65.3–95), 100% (93.9–100) and 95.2% (86.9–98.7) for local-R subcohort, respectively.</p> Conclusion <p>An AMRI protocol consisting of HBP and T2-weighted sequences has high SEN and NPV for detecting recurrent HCC and may be an acceptable secondary surveillance method for HCC patients following MWA, which may lead to decreased scan times and associated costs.</p>

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Hepatobiliary phase abbreviated MRI for secondary surveillance after microwave ablation of HCC

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月23日

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  • Pedram Keshavarz,
  • Kevin G. King,
  • Jena Depetris,
  • Matthew Quirk,
  • Tae W. Kang,
  • James Sayre,
  • Myron J. Tong,
  • Justin P. McWilliams,
  • Steven S. Raman,
  • David S. K. Lu

摘要

Purpose

To compare the diagnostic performance of an abbreviated MRI (AMRI) protocol consisting of hepatobiliary phase (HBP) and T2-weighted sequences versus complete-protocol MRI, for secondary surveillance in patients with hepatocellular carcinoma (HCC) after microwave ablation (MWA).

Methods

This retrospective cohort study included 43 HCC patients who underwent MWA between 2017 and 2019, comprising 27 consecutive patients with recurrence and 16 randomly selected patients without recurrence (to increase the proportion of negative MRI exams presented to readers), resulting in a total of 215 complete-protocol gadoxetic acid-enhanced surveillance MRI exams. Three blinded radiologists independently reviewed AMRI exams, which consisted of only HBP and T2-weighted sequences for each surveillance MRI, with access to pre- and post-complete-protocol MRIs for comparison. Diagnostic performance of AMRI was compared with the results from complete MRI protocol.

Results

Inter-reader agreement was excellent (κ = 0.91). Overall diagnostic performance per-patient and per-AMRI was as follows: sensitivity (SEN), specificity (SPE), and negative predictive value (NPV) of 86.4% (95%CI: 77.3–92.2), 100% (95.5–100), and 88.1% (79.8–93.2) for per-patient, and 87.5% (81.1–91.9), 97.6% (95–98.9) and 93.3% (89.7–95.7) for per-AMRI. Per-patient evaluation in the nonlocal-R subcohort showed SEN, SPE, and NPV of 86.6% (75.8–93.1), 100% (84.5–100), and 72.4% (54.3–85.3), compared with 85.7% (65.3–95), 100% (93.9–100) and 95.2% (86.9–98.7) for local-R subcohort, respectively.

Conclusion

An AMRI protocol consisting of HBP and T2-weighted sequences has high SEN and NPV for detecting recurrent HCC and may be an acceptable secondary surveillance method for HCC patients following MWA, which may lead to decreased scan times and associated costs.