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Gadoxetic acid-enhanced MRI detects PVT in patients with HCC

Gadoxetic acid–enhanced MRI was accurate in the detection of portal vein thrombosis in patients with hepatocellular carcinoma, as well as for differentiating between malignant and benign portal vein thrombosis, according to published findings.

In a retrospective study, researchers evaluated data of 366 patients with HCC who underwent gadoxetic acid–enhanced MRIs between January 2007 and May 2013. Of these, 134 had malignant portal vein thrombosis (PVT), 49 had benign PVT, and were matched for age and sex with 183 controls who did not have any evidence of PVT.

In patients with PVT, the PVTs were complete in 125 patients and partial in 58, located in a major portal vein (n = 159) or segmental portal vein (n = 24), according to the research.

MRIs were reviewed by two radiologists and assessed for sensitivity, specificity and accuracy in the detection and characterization of PVT according to major or segmental location and complete or partial type of PVT.

Overall, the gadoxetic acid–enhanced MRI showed good sensitivity for the detection of PVT (reviewer 1: 84% vs. reviewer 2: 70%), as well as high specificity (reviewer 1: 89% vs. reviewer 2: 96%).

In addition, the MRI was highly accurate in detecting differences between malignant PVT and benign PVT (reviewer 1: 92% vs. reviewer 2: 95%). However, sensitivity was lower for detecting segmental PVT compared with major PVT in the malignant PVT group for both reviewer 1 (95% vs. 88%; P = .203) and reviewer 2 (82% vs. 79%; P = .775).

The researchers concluded: “Caution is needed when evaluating potential candidates for curative treatment because of the low sensitivity for segmental PVT in the malignant PVT group.”

Disclosure: Healio.com/Hepatology was unable to confirm relevant financial disclosures at the time of publication.