Role of Multiparametric MRI in Characterization of Hepatocellular Carcinoma

Abstract

The detection and characterization of HCCs in patients with cirrhosis is important because surgical resection and/or transplantation offer the most effective treatment in patients with only limited disease. It is crucial not to apply radiofrequency ablation or chemoembolization on arterially enhanced pseudolesions or to miss early small HCCs. Distinguishing between HCC and benign hypervascular lesions in liver cirrhosis remains a major challenge in management of patients at risk for developing hepatocellular carcinoma. Biopsy of all lesions detected with MRI in the setting of liver cirrhosis would be impractical, extremely difficult, if not impossible, and likely to be of low yield. MRI is the most sensitive modality in detection and characterization of small hepatic focal lesions. MR imaging remains a highly accurate diagnostic method for the preoperative evaluation of HCC, and detection of small (≤ 2 cm) tumors has been significantly improved compared with that of earlier studies. The present study provides evidence to suggest that hepatic focal lesions encountered in the liver of patients with cirrhosis on dynamic gadolinium enhanced MRI images can be easily characterized, this offers avoiding of missing small, hypovascular or low grade HCCs from being managed and also avoiding offering loco-regional treatment for a benign lesion.