Gadoxetic acid-based hepatobiliary MRI in hepatocellular carcinoma
Jens Ricke,
Ingo G. Steffen,
Irene Bargellini,
Thomas Berg,
José Ignacio Bilbao Jaureguizar,
Bernhard Gebauer,
Roberto Iezzi,
Christian Loewe,
Musturay Karçaaltincaba,
Maciej Pech,
Christian Sengel,
Otto van Delden,
Vincent Vandecaveye,
Christoph J. Zech,
Max Seidensticker
Affiliations
Jens Ricke
Department of Radiology, Ludwig-Maximilians-University Munich, Munich, Germany; Corresponding author. Address: Department of Radiology, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377 Munich, Germany. Tel.: +49 4400 72750.
Ingo G. Steffen
Department of Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
Irene Bargellini
Department of Interventional Radiology, Pisa University Hospital, Pisa, Italy
Thomas Berg
Klinik und Poliklinik für Gastroenterologie, Sektion Hepatologie, Universitätsklinikum Leipzig AöR, Leipzig, Germany
José Ignacio Bilbao Jaureguizar
Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain
Bernhard Gebauer
Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
Roberto Iezzi
Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Radiologia, Rome, Italy
Christian Loewe
Section of Cardiovascular and Interventional Radiology, Department of Bioimaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
Musturay Karçaaltincaba
Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
Maciej Pech
Department of Radiology and Nuclear Medicine, University of Magdeburg, Magdeburg, Germany
Christian Sengel
Radiologie interventionnelle vasculaire et percutanée, CHU de Grenoble, Grenoble, France
Otto van Delden
Department of Radiology and Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Vincent Vandecaveye
Department of Radiology, University Hospitals Leuven, Leuven, Belgium
Christoph J. Zech
Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
Max Seidensticker
Department of Radiology, Ludwig-Maximilians-University Munich, Munich, Germany
Background & Aims: SORAMIC is a prospective phase II randomised controlled trial in hepatocellular carcinoma (HCC). It consists of 3 parts: a diagnostic study and 2 therapeutic studies with either curative ablation or palliative Yttrium-90 radioembolisation combined with sorafenib. We report the diagnostic cohort study aimed to determine the accuracy of gadoxetic acid-enhanced magnetic resonance imaging (MRI), including hepatobiliary phase (HBP) imaging features compared with contrast-enhanced computed tomography (CT). The primary objective was the accuracy of treatment decisions stratifying patients for curative or palliative (non-ablation) treatment. Methods: Patients with clinically suspected HCC underwent gadoxetic acid-enhanced MRI (HBP MRI, including dynamic MRI) and contrast-enhanced CT. Blinded read of the image data was performed by 2 reader groups (radiologists, R1 and R2). A truth panel with access to all clinical data and follow-up imaging served as reference. Imaging criteria for curative ablation were defined as up to 4 lesions 4 lesions significantly more frequently than CT. Conclusions: In HCC, HBP MRI provided a more accurate decision than CT for a curative vs. palliative treatment strategy. Lay summary: Patients with hepatocellular carcinoma are allocated to curative or palliative treatment according to the stage of their disease. Hepatobiliary imaging using gadoxetic acid-enhanced MRI is more accurate than CT for treatment decision-making.
