Detection of hepatocellular carcinoma arising in cirrhotic livers: comparison of gadolinium- and ferumoxides-enhanced MR imaging.
AJR Am J Roentgenol
; 172(6): 1547-54, 1999 Jun.
Article
in En
| MEDLINE
| ID: mdl-10350287
ABSTRACT
OBJECTIVE:
We prospectively compared the detectability of hepatocellular carcinoma (HCC) arising in cirrhotic livers using dynamic gadolinium-enhanced fast low-angle shot (FLASH), ferumoxides-enhanced T2-weighted turbo spin-echo, and ferumoxides-enhanced T2*-weighted FLASH MR imaging. SUBJECTS ANDMETHODS:
Fifty-three patients with HCC (32 men and 21 women) who were 33-86 years old (mean, 63 years old) were enrolled in a prospective MR study to assess hepatic lesions using both gadopentetate dimeglumine and ferumoxides. Dynamic gadolinium-enhanced imaging was obtained before and 30, 60, and 180 sec after rapid bolus injection of gadopentetate dimeglumine (0.1 mmol/kg). Ferumoxides-enhanced T2-weighted turbo spin-echo imaging and ferumoxides-enhanced T2*-weighted FLASH imaging were performed between 30 min and 2 hr after i.v. infusion of ferumoxides (10 micromol/kg). Images were analyzed qualitatively and quantitatively. A receiver operating characteristic curve study was performed to compare the diagnostic value of gadolinium-enhanced imaging with that of ferumoxides-enhanced imaging for the detection of HCC.RESULTS:
Quantitative analysis revealed a significantly higher percentage of signal-intensity loss and higher liver-lesion contrast-to-noise ratio on ferumoxides-enhanced T2*-weighted FLASH imaging than on ferumoxides-enhanced T2-weighted turbo spin-echo imaging. The percentage of signal-intensity loss and liver-lesion contrast-to-noise ratio on ferumoxides-enhanced images was significantly higher in patients with mild liver cirrhosis (Child's class A) than in patients with severe liver cirrhosis (Child's class C). Qualitative analysis showed that dynamic gadolinium-enhanced images revealed significantly higher lesion conspicuity than did ferumoxides-enhanced T2-weighted turbo spin-echo images. According to receiver operating characteristic analysis, dynamic gadolinium-enhanced FLASH imaging achieved the highest sensitivity, and ferumoxides-enhanced T2*-weighted FLASH imaging was the second most sensitive. We found that ferumoxides-enhanced turbo spin-echo imaging was the least valuable technique for revealing HCC lesions. Gadolinium-enhanced imaging revealed more HCC lesions than did ferumoxides-enhanced imaging, particularly for lesions smaller than 2 cm in diameter.CONCLUSION:
Ferumoxides-enhanced imaging revealed fewer findings, such as lesion conspicuity of HCCs arising in cirrhotic livers, than did gadolinium-enhanced FLASH imaging.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Oxides
/
Magnetic Resonance Imaging
/
Carcinoma, Hepatocellular
/
Contrast Media
/
Gadolinium DTPA
/
Iron
/
Liver Cirrhosis
/
Liver Neoplasms
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
AJR Am J Roentgenol
Year:
1999
Document type:
Article