OBJECTIVE. We compared the diagnostic performance of gadoxetic acid-enhanced MRI with that of triple-phase 16-, 40-, and 64-MDCT in the preoperative detection of hepa�tocellular carcinoma (HCC).
SUBJECTS AND METHODS. Sixty-two consecutively registered patients (54 men, eight women; age range, 31-67 years) with 83 HCCs underwent triple-phase (arterial, portal venous, equilibrium) CT at 16-, 40-, or 64-MDCT and gadoxetic acid-enhanced 3-T MRI. The diagnosis of HCC was established after surgical resection. Three observers independent�ly and randomly reviewed the MR and CT images on a tumor-by-tumor basis. The diagnos�tic accuracy of these techniques in the detection of HCC was assessed with alternative free response receiver operating characteristic (ROC) analysis. Sensitivity, positive and negative predictive values, and sensitivity according to tumor size were evaluated.
RESULTS. For each observer, the areas under the ROC curve were 0.971, 0.959, and 0.967 for MRI and 0.947, 0.950, and 0.943 for CT. The differences were not statistically sig�nificant between the two techniques for each observer (p > 0.05). The differences in sensitiv�ity and positive and negative predictive values between the two techniques for each observer were not statistically significant (p > 0.05). Among 10 HCCs 1 cm in diameter or smaller, each of the observers detected seven tumors with MRI. With CT, one observer detected five, one observer detected four, and one observer detected three HCCs with no statistically sig�nificant difference (p > 0.05).
CONCLUSION. Gadoxetic acid-enhanced MRI and triple-phase MDCT have similar diagnostic performance in the preoperative detection of HCC, but MRI may be better than MDCT in the detection of HCC 1 cm in diameter or smaller.