ArticleAbdominal radiology (New York)2026
Comparison of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MRI and contrast-enhanced CT evaluation of liver tumors: a prospective study.
Article in Abdominal radiology (New York), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis prospective study aimed to compare the diagnostic accuracy of hepatic lesions between contrast-enhanced computed tomography (CE-CT) and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-MRI). We also examined the final diagnosis of equivocal lesions.
methodsIn each patient undergoing hepatectomy for liver tumors, 2 radiologists (readers A and B) assessed CE-CT and Gd-EOB-MRI. Hepatic lesions were scored as 1, 2, 3, 4, or 5, which corresponded to categorization as benign, probably benign, equivocal, probably malignant, or malignant, respectively. Those scored as 1/2 and 4/5 were defined as benign and malignant, respectively. The lesions left unresected were confirmed as benign when they remained unchanged for ≥ 1 year after hepatectomy. The false-positive rate was defined as the number of lesions finally confirmed as benign among those assessed as malignant preoperatively.
resultsAmong 105 enrolled patients (colorectal liver metastases, 72; hepatocellular carcinoma, 29; other, 4), 886 lesions were recognized on either CT or MRI preoperatively; another 26 lesions were identified only on intraoperative ultrasonography or pathologic examination. The sensitivity of malignant lesion detection was significantly higher for Gd-EOB-MRI than CE-CT for both reader A (90.3% vs. 68.3%; P < 0.001) and reader B (88.1% vs. 70.2%; P < 0.001). The false-positive rate with CE-CT and Gd-EOB-MRI was 2.3% and 3.7%, respectively, for reader A (P = 0.580), and 0.5% and 4.2%, respectively, for reader B (P = 0.033). There were 142 lesions judged as equivocal in at least one of the imaging studies by either reader. Sixty-eight lesions (49%) were recognized as malignant by any of the alternative assessments; among these, 61were confirmed as malignant.
conclusionGd-EOB-MRI was superior to CE-CT for detecting liver lesions. The false-positive rate was low for both modalities. Equivocal lesions were encountered frequently, but routine use of alternate modalities and evaluation by 2 or more radiologists could enhance the accuracy of diagnosis.
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