ArticleEuropean radiology2026
Diagnosing HCC with conventional and late portal venous phase MRI: intraindividual comparison of MRI with extracellular contrast agent.
Article in European radiology, 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
objectivesTo evaluate the diagnostic performance of MRI with gadoxetate disodium (EOB-MRI) using conventional portal venous phase (CPVP) and late portal venous phase (LPVP) in the noninvasive diagnosis of hepatocellular carcinoma (HCC), with intraindividual comparison of MRI with extracellular contrast agent (ECA-MRI). MATERIALS AND
methodsThis retrospective study included 107 prospectively enrolled at-risk patients (mean age, 59.4 years; 89 men) with 143 lesions (118 HCCs) who underwent both ECA-MRI and EOB-MRI using CPVP and LPVP. Two radiologists assessed all lesions using LI-RADS v2018. The per-lesion diagnostic performance was compared using generalized estimating equations.
resultsIn HCCs, nonperipheral washout appearance was less frequent on EOB-MRI using CPVP than on ECA-MRI (R1: 69.5 vs. 79.7%, p = 0.02; R2: 66.9 vs. 76.3%, p = 0.02), but more frequent on EOB-MRI using LPVP than on ECA-MRI (R1: 94.1 vs. 79.7%, p < 0.001; R2: 92.4 vs. 76.3%, p < 0.001). For LR-5, EOB-MRI using LPVP showed significantly higher sensitivity for diagnosing HCC than ECA-MRI (R1, 80.5 vs. 72.0%, p = 0.03; R2: 79.7 vs. 71.2%, p = 0.01), while EOB-MRI using CPVP showed significantly lower sensitivity than ECA-MRI (R1: 64.4 vs. 72.0%, p = 0.03; R2: 64.4 vs. 71.2%, p = 0.03). The specificity of EOB-MRI using LPVP (both Readers: 88.0%) did not differ significantly from that of ECA-MRI (both Readers: 92.0%, p = 0.31) or EOB-MRI using CPVP (both Readers: 92.0%, p = 0.31).
conclusionsEOB-MRI using LPVP demonstrated higher sensitivity for HCC diagnosis than ECA-MRI and EOB-MRI using CPVP, while maintaining comparable specificity. KEY POINTS: Question MRI with gadoxetate disodium (EOB-MRI) using the late portal venous phase (LPVP) for HCC diagnosis has not been directly compared with MRI with extracellular contrast agent (ECA-MRI). Findings EOB-MRI using LPVP improved the sensitivity of HCC diagnoses compared with ECA-MRI and EOB-MRI using conventional portal venous phase, without compromising specificity. Clinical relevance EOB-MRI using LPVP may be a suitable option for HCC diagnosis, demonstrating higher sensitivity than ECA-MRI without compromising specificity.
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