Hepatocellular carcinoma: Association with increased iron deposition in the cirrhotic liver at MR imaging

PURPOSE: To determine whether the frequency of hepatocellular carcinoma (HC C) in patients with cirrhosis is affected by hepatic iron deposition as det ected with magnetic resonance (Mp) imaging. MATERIALS AND METHODS: In a retrospective search of MR imaging and histopat hology records, 196 patients with histopathologically proved cirrhosis and with (n = 80) or without (n = 116) HCC who underwent T2-weighted convention al or fast spin-echo and gradient-echo (CRE) (echo time greater than or equ al to 6.0 msec) imaging were identified. MR images were qualitatively and q uantitatively evaluated for diffuse hepatic iron deposition and siderotic r egenerative nodules to assess their correlation with the presence of HCC. RESULTS: Hepatic parenchymal iron deposition was seen in 79 (40%) patients, and iron deposition in regenerative nodules was seen in 71 (36%) at MR ima ging, The mean signal intensity ratio of GRE images in patients with hepati c iron deposition was significantly lower than that in patients without it (P <.001). The frequency of HCC in patients with iron deposition in regener ative nodules (52% [37 of 71 patients]) was significantly higher (P =.015) than that in patients without iron in regenerative nodules (34% [43 of 125 patients]). CONCLUSION: The occurrence of HCC may be associated causally with iron depo sition in regenerative nodules in patients with cirrhosis. MR imaging can e nable detection of iron deposition in regenerative nodules as a possible ri sk factor for the development of HCC.