The use of T2*-weighted multi-echo GRE imaging as a novel method to diagnose hepatocellular carcinoma compared with gadolinium-enhanced MRI: a feasibility study

Background: The goal of the study was to assess a T2*-weighted MRI sequence for the ability to identify hepatocellular carcinoma (HCC). Methods: Hepatic iron deposition, which is common in chronic liver disease (CLD), may increase the conspicuity of HCC on GRE imaging due to increased T2* signal decay in liver parenchyma. In this study, a breath-hold T2*-weighted MRI sequence was evaluated by a blinded observer for HCC and the results compared to a reference standard of gadolinium-enhanced MRI in these same patients. Forty-one patients (mean age 56.2 years; 17 females) were included in this approved, retrospective study. Results: By the reference standard, 14 of 41 patients had a total of 25 HCCs. The sensitivity of the T2*-weighted MR sequence for identifying HCC, per lesion, was 60%, while the specificity was 100%. There was a significantly lower T2* value of liver parenchyma in patients with HCC identified by the T2*-weighted sequence than in those with HCCs which were not identified by the T2*-weighted sequence (27.8 +/- 2.2 vs. 21.9 +/- 2.1 ms; P=.02). Conclusions: A T2*-weighted MRI sequence can identify HCC in patients with CLD. This technique may be beneficial for imaging of patients contraindicated for gadolinium. (C) 2010 Elsevier Inc. All rights reserved.