You have to keep in mind that they didn’t have to do what they did, but they did. After the procedure was done, Mike and Brian got me back into my wheelchair. I met Laura the MRI tech who further reassured me and made me feel comfortable. They struggled a little because you have to keep in mind that I am NOT a lightweight, but they got me in that chair. I made an appointment for 3/2/21 and when I showed up, Mike and Brian were waiting there and the both of them picked me up out of my wheelchair and placed me on the non metallic chair in the MRI room. After Lisa spoke to Mike and Brian, they agreed that I was going to get that MRI. I explained my situation to her and she said “let me see what I can do and I’ll get back to you” A little while later, Lisa called me and said that in order for ImageCare to help me, she would tell the owners, Mike and his son Brian about my situation. My first contact was with Lisa who is the sweetest, accommodating person that I’ve come across in a long time.
After searching the internet, I came across ImageCare in Denville, NJ. I am an old dinosaur, far from being in good health and I could not rely on my friends because they’re in even worse shape than me. A few of the imaging places that I contacted refused me because I am a wheelchair user (paraplegic) and I can not transfer from my wheelchair on my own. The last place that I had it done was no longer doing extremity MRI’s. However, for assessing the appropriateness of a transplantation recipient based on Milan criteria, MDCT, S-MRI, and DC-MRI showed comparable diagnostic accuracy without a statistical difference.Needed an MRI of my hand. This result might be because of the small number of patients who had a critical number of HCCs (ie, 2 approximately 4 HCCs).ĭC-MRI showed significantly better diagnostic performance in transplantation candidates for the detection of HCCs, particularly small HCCs, than both MDCT and S-MRI. However, significant differences were not seen for the predictions determined by both radiologists (P = 0.384-1). The AZ value for predicting the appropriateness for LT was highest with the use of S-MRI (0.841), followed by the use of DC-MRI (0.830) and the use of MDCT (0.790). The use of DC-MRI was significantly better than the use of the other 2 modalities specifically for HCCs smaller than 2 cm in diameter (P < 0.001) although not for those larger than or equal to 2 cm (P = 0.125-1). In terms of detecting HCCs, the reader-averaged figure of merit was highest for DC-MRI (0.764), followed by S-MRI (0.702) and MDCT (0.672). Among 80 patients included for the assessment of eligibility for LT, 69 recipients were categorized as appropriate and the remaining 11 patients were found to be inappropriate for LT based on Milan criteria. Twenty-seven HCCs were larger than 2 cm in diameter and 55 HCCs were smaller than 2 cm in diameter. Diagnostic performance of the 3 imaging techniques was compared using jackknife alternative free-response receiver operating characteristic and ROC analyses.Įighty-two HCCs were detected in 38 of 78 patients. Image interpretation was compared with histopathological results on a lesion-by-lesion basis. Two radiologists independently recorded confidence levels using a 4- and 5-point scale for the presence of HCC and for the appropriateness regarding LT, respectively. Interval readings for MDCT, S-MRI, and DC-MRI were performed. MDCT and DC-MRI examinations with the sequential use of SPIO and gadolinium were performed in all patients. However, 2 patients in whom >10 HCCs were present were excluded from the analysis of detection performance of imaging modalities for HCC. During a 3-year period, 80 patients who underwent LT were enrolled in this study. Requirement for patient informed consent was waived. This retrospective study received Institutional Review Board approval. To retrospectively evaluate the diagnostic performance of multidetector row CT (MDCT), superparamagnetic iron oxide (SPIO)-enhanced MRI (S-MRI), and dual-contrast MRI (DC-MRI) in predicting the appropriateness of recipients with hepatocellular carcinoma (HCC) for liver transplantation (LT), based on Milan criteria.
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