Radiology, Vol 195, 106-112, Copyright © 1995 by Radiological Society of North America

ARTICLES

Hepatocellular carcinoma in cirrhotic livers: detection with unenhanced and iron oxide-enhanced MR imaging

H Yamamoto, Y Yamashita, S Yoshimatsu, Y Baba, Y Hatanaka, R Murakami, T Nishiharu, M Takahashi, Y Higashida and N Moribe
Department of Radiology, Kumamoto University School of Medicine, Japan.

PURPOSE: To evaluate diagnostic accuracy with unenhanced and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging for detection of hepatocellular carcinoma (HCC) in cirrhotic livers. MATERIALS AND METHODS: Fifteen patients with 26 histologically proved HCCs associated with liver cirrhosis underwent imaging with T1-, T2-, and proton-density-weighted spin-echo (SE) and fast low-angle shot (FLASH) sequences. Lesion-to-liver contrast-to-noise ratios were measured in all sequences. Diagnostic performance of the imaging techniques was assessed by using receiver operating characteristic analysis. RESULTS: Enhanced SE and FLASH sequences were significantly more accurate (P < .005) for the detection of small HCCs. Among the unenhanced pulse sequences, the accuracy of tumor localization was highest with the T2-weighted SE sequences; however, 25% of the lesions were located incorrectly. Compared with unenhanced images, lesions were correctly located more often when SPIO-enhanced SE and FLASH sequences were used. CONCLUSION: SPIO-enhanced MR imaging with proton-density- weighted or FLASH sequences was more accurate in the detection of small HCCs in cirrhotic livers.

This article has been cited by other articles:

				A. M. Lutz, J. K. Willmann, K. Goepfert, B. Marincek, and D. Weishaupt Hepatocellular Carcinoma in Cirrhosis: Enhancement Patterns at Dynamic Gadolinium- and Superparamagnetic Iron Oxide-enhanced T1-weighted MR Imaging Radiology, November 1, 2005; 237(2): 520 - 528. [Abstract] [Full Text] [PDF]

				K T T Fung, F T W Li, M L Raimondo, D Maudgil, A Mancuso, J M Tibballs, A A Watkinson, D Patch, and A K Burroughs Systematic review of radiological imaging for hepatocellular carcinoma in cirrhotic patients Br. J. Radiol., August 1, 2004; 77(920): 633 - 640. [Abstract] [Full Text] [PDF]

				M. Matsuo, M. Kanematsu, K. Itoh, T. Murakami, Y. Maetani, H. Kondo, S. Goshima, N. Kako, H. Hoshi, J. Konishi, et al. Detection of Malignant Hepatic Tumors with Ferumoxides-Enhanced MRI: Comparison of Five Gradient-Recalled Echo Sequences with Different TEs Am. J. Roentgenol., January 1, 2004; 182(1): 235 - 242. [Abstract] [Full Text] [PDF]

				B. K. Kang, J. H. Lim, S. H. Kim, D. Choi, H. K. Lim, W. J. Lee, and S. J. Lee Preoperative Depiction of Hepatocellular Carcinoma: Ferumoxides-enhanced MR Imaging versus Triple-Phase Helical CT Radiology, January 1, 2003; 226(1): 79 - 85. [Abstract] [Full Text] [PDF]

				S. K. Kim, S. H. Kim, W. J. Lee, H. Kim, J. W. Seo, D. Choi, H. K. Lim, S. J. Lee, and J. H. Lim Preoperative Detection of Hepatocellular Carcinoma: Ferumoxides-Enhanced Versus Mangafodipir Trisodium--Enhanced MR Imaging Am. J. Roentgenol., September 1, 2002; 179(3): 741 - 750. [Abstract] [Full Text] [PDF]

				S. S. Raman, D. S. K. Lu, S. C. Chen, J. Sayre, F. Eilber, and J. Economou Hepatic MR Imaging Using Ferumoxides: Prospective Evaluation with Surgical and Intraoperative Sonographic Confirmation in 25 Cases Am. J. Roentgenol., October 1, 2001; 177(4): 807 - 812. [Abstract] [Full Text] [PDF]

				M. Matsuo, M. Kanematsu, K. Itoh, K. Ito, Y. Maetani, H. Kondo, N. Kako, N. Matsunaga, H. Hoshi, and J. Shiraishi Detection of Malignant Hepatic Tumors: Comparison of Gadolinium-and Ferumoxide-Enhanced MR Imaging Am. J. Roentgenol., September 1, 2001; 177(3): 637 - 643. [Abstract] [Full Text] [PDF]

				J. H. Lim, D. Choi, S. K. Cho, S. H. Kim, W. J. Lee, H. K. Lim, C. K. Park, S. W. Paik, and Y. I. Kim Conspicuity of Hepatocellular Nodular Lesions in Cirrhotic Livers at Ferumoxides-enhanced MR Imaging: Importance of Kupffer Cell Number Radiology, September 1, 2001; 220(3): 669 - 676. [Abstract] [Full Text] [PDF]

				D. Choi, S. H. Kim, J. H. Lim, W. J. Lee, H.-J. Jang, S. J. Lee, and H. K. Lim Preoperative Detection of Hepatocellular Carcinoma: Ferumoxides-Enhanced MR Imaging Versus Combined Helical CT During Arterial Portography and CT Hepatic Arteriography Am. J. Roentgenol., February 1, 2001; 176(2): 475 - 482. [Abstract] [Full Text] [PDF]

				K. Mori, H. Yoshioka, Y. Itai, Y. Okamoto, H. Mori, N. Takahashi, and Y. Saida Arterioportal Shunts in Cirrhotic Patients: Evaluation of the Difference Between Tumorous and Nontumorous Arterioportal Shunts on MR Imaging with Superparamagnetic Iron Oxide Am. J. Roentgenol., December 1, 2000; 175(6): 1659 - 1664. [Abstract] [Full Text] [PDF]

				J. Ward, J. A. Guthrie, D. J. Scott, J. Atchley, D. Wilson, M. H. Davies, J. I. Wyatt, and P. J. Robinson Hepatocellular Carcinoma in the Cirrhotic Liver: Double-Contrast MR Imaging for Diagnosis Radiology, July 1, 2000; 216(1): 154 - 162. [Abstract] [Full Text]

				H. Kondo, M. Kanematsu, H. Hoshi, T. Murakami, T. Kim, M. Hori, M. Matsuo, and H. Nakamura Preoperative Detection of Malignant Hepatic Tumors: Comparison of Combined Methods of MR Imaging with Combined Methods of CT Am. J. Roentgenol., April 1, 2000; 174(4): 947 - 954. [Abstract] [Full Text] [PDF]

				D. Pauleit, J. Textor, R. Bachmann, R. Conrad, S. Flacke, G. Layer, B. Kreft, and H. Schild Hepatocellular Carcinoma: Detection with Gadolinium- and Ferumoxides-enhanced MR Imaging of the Liver Radiology, January 1, 2002; 222(1): 73 - 80. [Abstract] [Full Text] [PDF]