Evidence map›Paper›PMID 36158916›Full record

ArticleWorld journal of hepatology2022

Hepatobiliary phases in magnetic resonance imaging using liver-specific contrast for focal lesions in clinical practice.

Daniel Alvarenga Fernandes, Eduardo Andreazza Dal Lago, Felipe Aguera Oliver, Bruna Melo Coelho Loureiro, Daniel Lahan Martins, Thiago José Penachim, Ricardo Hoelz de Oliveira Barros, José de Arimatéia Batista Araújo Filho, Larissa Bastos Eloy da Costa, Áurea Maria Oliveira da Silva and 3 more

Abstract read
In one paragraph

Article in World journal of hepatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Daniel Alvarenga FernandesDepartment of Radiology, School of Medical Sciences, University of Campinas- UNICAMP, Campinas 13083-888, São Paulo, Brazil.
Eduardo Andreazza Dal LagoDepartment of Radiology, School of Medical Sciences, University of Campinas- UNICAMP, Campinas 13083-888, São Paulo, Brazil.
Felipe Aguera OliverDepartment of Radiology, Medical School, São Paulo State University- UNESP, Botucatu 18618-970, São Paulo, Brazil.
Bruna Melo Coelho LoureiroInstituto de Radiologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo- InRad/HC-FMUSP, São Paulo 05403-010, SP, Brazil.
Daniel Lahan MartinsDepartment of Radiology, School of Medical Sciences, University of Campinas- UNICAMP, Campinas 13083-888, São Paulo, Brazil.
Thiago José PenachimDepartment of Radiology, School of Medical Sciences, University of Campinas- UNICAMP, Campinas 13083-888, São Paulo, Brazil.
Ricardo Hoelz de Oliveira BarrosDepartment of Radiology, School of Medical Sciences, University of Campinas- UNICAMP, Campinas 13083-888, São Paulo, Brazil.
José de Arimatéia Batista Araújo FilhoDepartment of Radiology, Sírio- Libanês Hospital, São Paulo 05652-900, SP, Brazil.
Larissa Bastos Eloy da CostaDepartment of Pathology, School of Medical Sciences, University of Campinas - UNICAMP, Campinas 13083-888, São Paulo, Brazil.
Áurea Maria Oliveira da SilvaLiver Transplant Unit, Department of Surgery, School of Medical Sciences, University of Campinas- UNICAMP, Campinas 13083-888, São Paulo, Brazil.
Elaine Cristina de AtaídeLiver Transplant Unit, Department of Surgery, School of Medical Sciences, University of Campinas- UNICAMP, Campinas 13083-888, São Paulo, Brazil.
Ilka de Fátima Santana Ferreira BoinLiver Transplant Unit, Department of Surgery, School of Medical Sciences, University of Campinas- UNICAMP, Campinas 13083-888, São Paulo, Brazil.
Nelson Marcio Gomes CasertaDepartment of Radiology, School of Medical Sciences, University of Campinas- UNICAMP, Campinas 13083-888, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChallenging lesions, difficult to diagnose through non-invasive methods, constitute an important emotional burden for each patient regarding a still uncertain diagnosis (malignant x benign). In addition, from a therapeutic and prognostic point of view, delay in a definitive diagnosis can lead to worse outcomes. One of the main innovative trends currently is the use of molecular and functional methods to diagnosis. Numerous liver-specific contrast agents have been developed and studied in recent years to improve the performance of liver magnetic resonance imaging (MRI). More recently, one of the contrast agents introduced in clinical practice is gadoxetic acid (gadoxetate disodium).

aimTo demonstrate the value of the hepatobiliary phases using gadoxetic acid in MRI for the characterization of focal liver lesions (FLL) in clinical practice.

methodsOverall, 302 Lesions were studied in 136 patients who underwent MRI exams using gadoxetic acid for the assessment of FLL. Two radiologists independently reviewed the MRI exams using four stages, and categorized them on a 6-point scale, from 0 (lesion not detected) to 5 (definitely malignant). The stages were: stage 1- images without contrast, stage 2- addition of dynamic phases after contrast (analogous to usual extracellular contrasts), stage 3- addition of hepatobiliary phase after 10 min (HBP 10'), stage 4- hepatobiliary phase after 20 min (HBP 20') in addition to stage 2.

resultsThe interobserver agreement was high (weighted Kappa coefficient: 0.81- 1) at all stages in the characterization of benign and malignant FLL. The diagnostic weighted accuracy (Az) was 0.80 in stage 1 and was increased to 0.90 in stage 2. Addition of the hepatobiliary phase increased Az to 0.98 in stage 3, which was also 0.98 in stage 4.

conclusionThe hepatobiliary sequences improve diagnostic accuracy. With growing potential in the era of precision medicine, the improvement and dissemination of the method among medical specialties can bring benefits in the management of patients with FLL that are difficult to diagnose.

Indexed as

Diagnostic imagingLiverLiver neoplasmsLiver transplantationMagnetic resonance imagingMedical oncology

Identifiers

PMID36158916
PMCPMC9376775

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.