Diagnostic performance of abbreviated MRI in surveillance of patients with hepatocellular carcinoma candidates for liver transplantation

PURPOSE: To compare the diagnostic performance of three different abbreviated MRI protocols simulated by extraction from a standard liver MRI protocol with hepatobiliary-specific contrast agent obtained for hepatocellular carcinoma (HCC) surveillance in patients candidates for liver transplantation. METHODS: We conducted a retrospective study on cirrhotic patient population, undergoing MRI surveillance for HCC. All patients were candidates to liver transplantation with a total of 105/195 patients previously treated with liver-directed therapy. From the complete liver MRI with hepatobiliary-specific contrast agent (cMRI), three simulated abbreviated MRI protocols were extracted: dynamic contrast-enhanced abbreviated MRI (Dyn-AMRI); hepatobiliary phase abbreviated MRI (HBP-AMRI) and non-enhanced abbreviated MRI (NE-AMRI). Three abdominal radiologists independently interpreted the simulated protocols. RESULTS: 195 cirrhotic patients, candidates for liver transplantation, were analyzed. The overall sensitivity, specificity and accuracy of AMRI for HCC detection were 94%, 96% and 94% for Dyn-AMRI, 93%, 94% and 93% for HBP-AMRI, 90%, 90% and 90% for NE-AMRI. The interchangeability analysis revealed no significant difference between HBP-AMRI and cMRI and between cMRI and Dyn-AMRI. Regarding equivalence, agreement and interchangeability analysis, no significant differences were found in detection of HCC in patients previously undergoing liver-directed therapy. CONCLUSION: Both Dyn-AMRI and HBP-AMRI could be used in surveillance of cirrhotic patients, even after previous liver-direct therapy.