Natural course of hypovascular nodules detected on gadoxetic acid-enhanced MR imaging

Presence of fat is a risk factor for hypervascularization

Dai Joishi, Akihisa Ueno, Akihiro Tanimoto, Shigeo Okuda, Yohei Masugi, Katsura Emoto, Kiyoshi Okuma, Michiie Sakamoto, Yutaka Imai, Sachio Kuribayashi

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: Hypovascular nodules that exhibit hypointensity in hepatocyte-phase images of gadoxetic acid-enhanced magnetic resonance (MR) imaging are frequently encountered in clinical practice. We investigated risk factors for the development of these nodules into hypervascular hepatocellular carcinoma (HCC). Methods: We retrospectively reviewed our institutional database and identified 302 patients who underwent gadoxetic acid-enhanced MR imaging for suspected or confirmed HCC from February 1, 2008 to January 30, 2011. We excluded patients who were examined for metastasis of other malignancies or for other hepatic tumors, such as focal nodular hyperplasia. We identified hypovascular nodules that were hypointense in hepatocyte-phase images, recorded their characteristics, and calculated the cumulative hypervascularization rate for nodules that were followed up. Results: Of the 302 patients, 82 had hypovascular nodules (178 nodules; mean size, 9.3 mm). Sixty nodules were followed up for over 6 months, and eight progressed to hypervascular HCC. Hypervascularization occurred more frequently in nodules with fat than those without (P<0.01). The cumulative hypervascularization rate was 5.1% over a year. Conclusion: The presence of intralesional fat was found to be a risk factor for hypervascularization of hypovascular nodules that exhibited hypointensity in the hepatocyte-phase images of gadoxetic acid-enhanced MR imaging.

Original languageEnglish
Pages (from-to)281-287
Number of pages7
JournalMagnetic Resonance in Medical Sciences
Volume12
Issue number4
DOIs
Publication statusPublished - 2013

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Hepatocytes
Hepatocellular Carcinoma
Fats
Magnetic Resonance Imaging
Focal Nodular Hyperplasia
Neoplasms
Databases
Neoplasm Metastasis
Liver
gadolinium ethoxybenzyl DTPA

Keywords

  • Gadoxetic acid
  • Hepatocellular carcinoma
  • Liver
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Natural course of hypovascular nodules detected on gadoxetic acid-enhanced MR imaging: Presence of fat is a risk factor for hypervascularization",
abstract = "Purpose: Hypovascular nodules that exhibit hypointensity in hepatocyte-phase images of gadoxetic acid-enhanced magnetic resonance (MR) imaging are frequently encountered in clinical practice. We investigated risk factors for the development of these nodules into hypervascular hepatocellular carcinoma (HCC). Methods: We retrospectively reviewed our institutional database and identified 302 patients who underwent gadoxetic acid-enhanced MR imaging for suspected or confirmed HCC from February 1, 2008 to January 30, 2011. We excluded patients who were examined for metastasis of other malignancies or for other hepatic tumors, such as focal nodular hyperplasia. We identified hypovascular nodules that were hypointense in hepatocyte-phase images, recorded their characteristics, and calculated the cumulative hypervascularization rate for nodules that were followed up. Results: Of the 302 patients, 82 had hypovascular nodules (178 nodules; mean size, 9.3 mm). Sixty nodules were followed up for over 6 months, and eight progressed to hypervascular HCC. Hypervascularization occurred more frequently in nodules with fat than those without (P<0.01). The cumulative hypervascularization rate was 5.1{\%} over a year. Conclusion: The presence of intralesional fat was found to be a risk factor for hypervascularization of hypovascular nodules that exhibited hypointensity in the hepatocyte-phase images of gadoxetic acid-enhanced MR imaging.",
keywords = "Gadoxetic acid, Hepatocellular carcinoma, Liver, Magnetic resonance imaging",
author = "Dai Joishi and Akihisa Ueno and Akihiro Tanimoto and Shigeo Okuda and Yohei Masugi and Katsura Emoto and Kiyoshi Okuma and Michiie Sakamoto and Yutaka Imai and Sachio Kuribayashi",
year = "2013",
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T1 - Natural course of hypovascular nodules detected on gadoxetic acid-enhanced MR imaging

T2 - Presence of fat is a risk factor for hypervascularization

AU - Joishi, Dai

AU - Ueno, Akihisa

AU - Tanimoto, Akihiro

AU - Okuda, Shigeo

AU - Masugi, Yohei

AU - Emoto, Katsura

AU - Okuma, Kiyoshi

AU - Sakamoto, Michiie

AU - Imai, Yutaka

AU - Kuribayashi, Sachio

PY - 2013

Y1 - 2013

N2 - Purpose: Hypovascular nodules that exhibit hypointensity in hepatocyte-phase images of gadoxetic acid-enhanced magnetic resonance (MR) imaging are frequently encountered in clinical practice. We investigated risk factors for the development of these nodules into hypervascular hepatocellular carcinoma (HCC). Methods: We retrospectively reviewed our institutional database and identified 302 patients who underwent gadoxetic acid-enhanced MR imaging for suspected or confirmed HCC from February 1, 2008 to January 30, 2011. We excluded patients who were examined for metastasis of other malignancies or for other hepatic tumors, such as focal nodular hyperplasia. We identified hypovascular nodules that were hypointense in hepatocyte-phase images, recorded their characteristics, and calculated the cumulative hypervascularization rate for nodules that were followed up. Results: Of the 302 patients, 82 had hypovascular nodules (178 nodules; mean size, 9.3 mm). Sixty nodules were followed up for over 6 months, and eight progressed to hypervascular HCC. Hypervascularization occurred more frequently in nodules with fat than those without (P<0.01). The cumulative hypervascularization rate was 5.1% over a year. Conclusion: The presence of intralesional fat was found to be a risk factor for hypervascularization of hypovascular nodules that exhibited hypointensity in the hepatocyte-phase images of gadoxetic acid-enhanced MR imaging.

AB - Purpose: Hypovascular nodules that exhibit hypointensity in hepatocyte-phase images of gadoxetic acid-enhanced magnetic resonance (MR) imaging are frequently encountered in clinical practice. We investigated risk factors for the development of these nodules into hypervascular hepatocellular carcinoma (HCC). Methods: We retrospectively reviewed our institutional database and identified 302 patients who underwent gadoxetic acid-enhanced MR imaging for suspected or confirmed HCC from February 1, 2008 to January 30, 2011. We excluded patients who were examined for metastasis of other malignancies or for other hepatic tumors, such as focal nodular hyperplasia. We identified hypovascular nodules that were hypointense in hepatocyte-phase images, recorded their characteristics, and calculated the cumulative hypervascularization rate for nodules that were followed up. Results: Of the 302 patients, 82 had hypovascular nodules (178 nodules; mean size, 9.3 mm). Sixty nodules were followed up for over 6 months, and eight progressed to hypervascular HCC. Hypervascularization occurred more frequently in nodules with fat than those without (P<0.01). The cumulative hypervascularization rate was 5.1% over a year. Conclusion: The presence of intralesional fat was found to be a risk factor for hypervascularization of hypovascular nodules that exhibited hypointensity in the hepatocyte-phase images of gadoxetic acid-enhanced MR imaging.

KW - Gadoxetic acid

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