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Article

Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients

1
Radiology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy
2
Division of Radiology, University of Campania Luigi Vanvitelli, 80127 Naples, Italy
3
Hepatobiliary Surgical Oncology Division, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, 80131 Naples, Italy
4
Division of Radiology, “Azienda Ospedaliera Universitaria Careggi”, 50139 Florence, Italy
5
Radiology Division, Università degli Studi del Molise, Via Francesco De Sanctis, 86100 Campobasso, Italy
6
Fondazione SIRM, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Paul. B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(7), 3598; https://doi.org/10.3390/ijerph18073598
Received: 23 February 2021 / Revised: 26 March 2021 / Accepted: 28 March 2021 / Published: 30 March 2021
(This article belongs to the Special Issue The Evolving Role of Diagnostic Imaging Service in Public Health)
Background: Liver Imaging Reporting and Data Systems (LI-RADS) Treatment Response Algorithm (TRA) was created to provide a standardized assessment of hepatocellular carcinoma (HCC) following loco regional therapy. The aim of this study was to compare sensitivity of standard MRI protocol versus abbreviated protocol (only T1-Weigthed fat suppressed (FS) sequences pre- and post-contrast phase) in the detection of ablated area according to LI-RADS Treatment Response (LR-TR) categories. Methods: From January 2015 to June 2020, we selected 64 patients with HCC, who underwent Radiofrequency ablation (RFA) or Microwave ablation (MWA) treatment. According to inclusion criteria, 136 pathologically proven treated HCC (median 2, range 1–3 per patient; mean size 20.0 mm; range 15–30 mm) in 58 patients (26 women, 32 men; median age, 74 years; range, 62–83 years) comprised our study population. For each ablated area, abbreviated protocol, and standard Magnetic Resonance Imaging (MRI) studies were independently and blindly assessed in random order within and between three expert radiologists. Each radiologist assessed the ablated area by using the following categories: “LR-TR Non-viable” = 1; “LR-TR Equivocal” = 2 and “LR-TR Viable” = 0. Results: According to the concordance between MRI and Contrast enhancement ultrasound (CEUS) among 136 treated HCCs, 115 lesions were assessed as non-viable or totally ablate and 21 as viable or partially ablate. The accuracy for standard MRI protocol and abbreviated MRI protocol for predicting pathologic tumor viability of a consensus reading was 98.6% (sensitivity = 100%; specificity = 98.3%; positive predictive value = 91.3% and negative predictive value = 100%). No differences were found in sensitivity or specificity between standard MRI LR-TR viable and abbreviated MRI LR-TR viable categories (p value > 0.05 at McNemar test). Conclusion: The abbreviated dynamic protocol showed similar diagnostic accuracy to conventional MRI study in the assessment of treated HCCs, with a reduction of the acquisition study time of 30% respect to conventional MRI. View Full-Text
Keywords: HCC; ablation treatment; magnetic resonance imaging; DWI; contrast enhancement MRI HCC; ablation treatment; magnetic resonance imaging; DWI; contrast enhancement MRI
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MDPI and ACS Style

Granata, V.; Grassi, R.; Fusco, R.; Setola, S.V.; Belli, A.; Piccirillo, M.; Pradella, S.; Giordano, M.; Cappabianca, S.; Brunese, L.; Grassi, R.; Petrillo, A.; Izzo, F. Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients. Int. J. Environ. Res. Public Health 2021, 18, 3598. https://doi.org/10.3390/ijerph18073598

AMA Style

Granata V, Grassi R, Fusco R, Setola SV, Belli A, Piccirillo M, Pradella S, Giordano M, Cappabianca S, Brunese L, Grassi R, Petrillo A, Izzo F. Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients. International Journal of Environmental Research and Public Health. 2021; 18(7):3598. https://doi.org/10.3390/ijerph18073598

Chicago/Turabian Style

Granata, Vincenza, Roberta Grassi, Roberta Fusco, Sergio V. Setola, Andrea Belli, Mauro Piccirillo, Silvia Pradella, Marzia Giordano, Salvatore Cappabianca, Luca Brunese, Roberto Grassi, Antonella Petrillo, and Francesco Izzo. 2021. "Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients" International Journal of Environmental Research and Public Health 18, no. 7: 3598. https://doi.org/10.3390/ijerph18073598

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