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The role of dynamic subtraction MRI in detection of hepatocellular carcinoma.

PURPOSE
The aim of this study was to investigate the role of dynamic subtraction magnetic resonance imaging (MRI) in detection of hepatocellular carcinoma (HCC) in patients with cirrhosis.


MATERIALS AND METHODS
MR images of 32 patients with cirrhosis were retrospectively investigated. The standard sequence images of the patients were evaluated for detection of HCC, and then the subtracted images of dynamic contrast-enhanced series were evaluated. The sensitivity, specificity, and accuracy of standard technique and additional use of subtracted images were investigated.


RESULTS
In detection of at least one HCC, standard protocol was useful in 14 of 17 (82.3%) patients; by additional use of subtraction imaging all 17 (100%) patients with HCC were detected. For detection of the correct number of HCC tumors, standard protocol was found to have 61.5% sensitivity, 78.9% specificity, and 71.8% accuracy. The use of subtracted images increased the sensitivity to 85.7%, specificity to 83.3%, and accuracy to 84.3%.


CONCLUSION
Subtraction is a simple automatic procedure that is commonly available in most MRI systems. The use of subtraction of dynamic contrast-enhanced series facilitates the detection of HCC in disorganized architecture of cirrhotic livers.