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Performance of Gadoxetic AcidEnhanced Liver Magnetic Resonance Imaging for Predicting Patient Eligibility for Liver Transplantation Based on the Milan Criteria

Jang, Hwi Young MD; Choi, Joon-Il MD, PhD; Lee, Young Joon MD; Park, Michael Yong MD; Yeo, Dong Myung MD; Rha, Sung Eun MD; Jung, Eun Sun MD; You, Young Kyoung MD; Kim, Dong Goo MD; Byun, Jae Young MD

Journal of Computer Assisted Tomography: January 2017 - Volume 41 - Issue 1 - p 25–31
doi: 10.1097/RCT.0000000000000476
Abdominal Imaging

Purpose: This study aimed to evaluate the accuracy of gadoxetic acid–enhanced magnetic resonance imaging (Gd-EOB-MRI) in predicting eligibility for liver transplantation in patients with hepatocellular carcinoma (HCC) based on Milan criteria (MC).

Materials and Methods: We reviewed Gd-EOB-MRI of 44 patients who underwent liver transplantation for HCC with cirrhosis for the presence/size of HCCs, vascular invasion, and transplant eligibility based on MC. Hepatocellular carcinoma was diagnosed based on conventional radiological hallmarks (arterial enhancement and washout) or the modified criteria.

Results: Among 44 patients, 16 was beyond MC. Sensitivity, specificity, and accuracy of conventional radiological hallmark and the modified criteria for predicting eligibility by MC were 31.3%, 96.3%, and 72.7%, and 68.8%, 96.3%, and 86.4%, respectively.

Conclusions: Gd-EOB-MRI showed high specificity but poor sensitivity for assessing transplant eligibility based on MC when adopting the conventional radiological hallmarks of HCC. Our modified criteria showed significantly better sensitivity and accuracy than the conventional radiological hallmarks.

From the *Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul; †Department of Radiology, Daejeon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon; and Departments of ‡Hospital Pathology, and §Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Received for publication February 21, 2016; accepted May 2, 2016.

Correspondence to: Joon-Il Choi, MD, PhD, Department of Radiology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea (e-mail: dumkycji@gmail.com).

This research was supported by a grant of the Korean Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (Grant HI15C0833) and a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (Grant 150160).

The authors declare no conflict of interest.

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