Quantitative evaluation of Gd-EOB-DTPA uptake in focal liver lesions by using T1 mapping: differences between hepatocellular carcinoma, hepatic focal nodular hyperplasia and cavernous hemangioma.

OBJECTIVES: To investigate the difference of T1 relaxation time on Gd-EOB-DTPA-enhanced MRI in hepatocellular carcinoma (HCC), hepatic focal nodular hyperplasia (FNH) and cavernous hemangioma of liver (CHL), and to quantitatively evaluate the uptake of Gd-EOB-DTPA in these three focal liver lesions (FLLs).

RESULTS: The T1P of CHL was significantly higher than those of HCC and FNH ( P < 0.05). Reduction of T1 relaxation time on hepatobiliary phase could be observed in all three types of lesions. There were significant differences of T1P , T1E , T1D and T1D % between FNH, CHL and HCC ( P < 0.001). Spearman correlation analysis revealed that T1D % was the best indicator for diagnostic differentiation, with a correlation coefficient of 0.702. Discriminant analysis using three variables (T1P , T1E , and T1D %) showed that the classification accuracy was 88.2%.

MATERIALS AND METHODS: 74 patients diagnosed with focal liver lesions underwent Gd-EOB-DTPA-enhanced MRI including T1 mapping were enrolled, consisting of 51 HCCs, 10 FNHs, and 13 CHLs. T1 relaxation times of these lesions were measured on pre-contrast (T1P ) and on hepatobiliary phase images at 20 minute after contrast (T1E ). The reduction of T1 relaxation time on hepatobiliary (T1D ) and the percentage reduction (T1D %) was calculated. The differences of T1P , T1E , T1D and T1D % in these FLLs were analyzed. The usefulness of these parameters for classification of FLLs was evaluated.

CONCLUSIONS: Uptake of Gd-EOB-DTPA is different between in HCC, FNH and CHL. These three lesions can be distinguished using T1 mapping.