Diagnostic Accuracy of MRI in Differentiating Hepatocellular Adenoma From Focal Nodular Hyperplasia: Prospective Study of the Additional Value of Gadoxetate Disodium

OBJECTIVE. The purpose of this article is to prospectively determine the sensitivity of hepatobiliary phase gadoxetate disodium–enhanced MRI combined with standard MRI in differentiating focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA). SUBJECTS AND METHODS. Patients suspected of having FNH or HCA larger than 2 cm underwent gadoxetate disodium–enhanced MRI. Standard MRI was evaluated separately from the additional hepatobiliary phase by two blinded radiologists. For the largest lesion in each patient, findings were compared with histologic diagnosis. Sensitivity, positive predictive value (PPV), and distinctive features were analyzed using McNemar and analysis of variance tests. RESULTS. Fifty-two patients completed the study. Histologic diagnosis revealed 24 HCAs and 28 FNHs. Characterization on standard MRI was inconclusive in 40% (21/52) and conclusive in 60% (31/52) of lesions. The sensitivity of standard MRI for HCA was 50% (12/24) with a PPV of 100% (12/12). The sensitivity for FNH ...