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Clinical Significance of the Transitional Phase at Gadoxetate Disodium–Enhanced Hepatic MRI for the Diagnosis of Hepatocellular Carcinoma: Preliminary Results

Nakamura, Yuko MD*; Toyota, Naoyuki MD; Shuji Date, *; Oda, Seitaro MD; Namimoto, Tomohiro MD; Yamashita, Yasuyuki MD; Beppu, Toru MD§; Awai, Kazuo MD*

Journal of Computer Assisted Tomography: November/December 2011 - Volume 35 - Issue 6 - p 723–727
doi: 10.1097/RCT.0b013e3182372c40
Original Article

Objectives To investigate the clinical significance of the “transitional phase” at gadoxetate disodium (Gd-EOB)–enhanced magnetic resonance imaging for diagnosing hepatocellular carcinoma (HCC).

Methods We studied 54 patients with 70 histologically diagnosed HCC. Transitional- and hepatobiliary-phase (TP, HBP) images were acquired 3 and 20 minutes after Gd-EOB injection, respectively. Radiologists measured the size of the hepatic tumors on images and surgical specimens and qualitatively evaluated the signal intensity of the hepatic tumors during TP and HBP independently.

Results In 4 patients with portal tumor embolism who had undergone percutaneous transhepatic portal embolization and who manifested arterioportal (AP) shunts, the low-intensity area was larger during HBP than TP. Of the 70 HCCs, 4 were of high signal intensity during HBP and 2 were of slightly low intensity during TP.

Conclusion Tumor extension seen during TP rather than HBP more accurately reflected histological findings in patients with HCC with portal tumor thrombi, percutaneous transhepatic portal embolization, or AP shunt.

From the *Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University; †Radiology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center; and ‡Diagnostic Radiology, and §Gastroenterological Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.

Received for publication June 24, 2011; accepted September 12, 2011.

Reprints: Yuko Nakamura, MD, Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan (e-mail:

The authors have no conflict of interest and source of funding to declare.

© 2011 Lippincott Williams & Wilkins, Inc.