| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Gastrointestinal Imaging |
1 From the Departments of Radiology, MRI Unit (J.W., J.A.G., D.J.S., J.A., P.J.R.), Medical Physics (D.W.), Hepatology (M.H.D.), and Pathology (J.I.W.), St James's University Hospital, Beckett Street, Leeds LS9 7TF, United Kingdom. From the 1999 RSNA scientific assembly. Received August 13, 1999; revision requested October 7; revision received November 1; accepted November 10. Address correspondence to J.W. (e-mail: Janice.Ward@gw.sjsuh.northy.nhs.uk).
PURPOSE: To measure the sensitivity and accuracy of double-contrast magnetic resonance (MR) imaging for the diagnosis of hepatocellular carcinoma (HCC) in the cirrhotic liver.
MATERIALS AND METHODS: Twenty-seven patients with MR features of dysplastic nodules and/or HCC were examined. T2-weighted spin-echo and T1-weighted gradient-echo imaging was performed before and after superparamagnetic iron oxide (SPIO) administration and immediately followed by T1-weighted gradient-echo imaging at 10, 40, and 120 seconds after bolus injection of a gadolinium-based contrast material. Nonenhanced, nonenhanced plus SPIO-enhanced, and nonenhanced plus SPIO-enhanced plus gadolinium-enhanced images were reviewed. Alternative–free response receiver operating characteristic (ROC) methodology was used to analyze the results, which were correlated with histopathologic findings after transplantation in 15 patients and at biopsy in 12. Lesions visualized with all three techniques were characterized as a dysplastic nodule or HCC, and ROC analysis was performed.
RESULTS: For all observers, SPIO-enhanced MR imaging (mean accuracy, 0.76) was more accurate than nonenhanced MR imaging (mean accuracy, 0.64) (P < .04), and double-contrast MR imaging (mean accuracy, 0.86) was more accurate than SPIO-enhanced imaging (P < .05). Both types of lesions were correctly characterized with all three techniques, although observer confidence for lesion characterization was greatest with double-contrast MR imaging.
CONCLUSION: Double-contrast MR imaging significantly improves the diagnosis of HCC compared with SPIO-enhanced and nonenhanced imaging (P < .01).
Index terms: Gadolinium • Iron • Liver neoplasms, 761.31, 761.323 • Liver neoplasms, MR, 761.121411, 761.121412, 761.121416, 761.12143 • Magnetic resonance (MR), comparative studies, 761.121411, 761.121412, 761.121416, 761.12143 • Magnetic resonance (MR), contrast enhancement, 761.12143 • Magnetic resonance (MR), contrast media, 761.12143
This article has been cited by other articles:
|
|
 |
|
  Y K KIM, C S KIM, and Y M HAN Detection of small hepatocellular carcinoma: comparison of conventional gadolinium-enhanced MRI with gadolinium-enhanced MRI after the administration of ferucarbotran Br. J. Radiol., June 1, 2009; 82(978): 468 - 484. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Willatt, H. K. Hussain, S. Adusumilli, and J. A. Marrero MR Imaging of Hepatocellular Carcinoma in the Cirrhotic Liver: Challenges and Controversies Radiology, May 1, 2008; 247(2): 311 - 330. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. F. Hanna, D. A. Aguirre, N. Kased, S. C. Emery, M. R. Peterson, and C. B. Sirlin Cirrhosis-associated Hepatocellular Nodules: Correlation of Histopathologic and MR Imaging Features RadioGraphics, May 1, 2008; 28(3): 747 - 769. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. F. Hanna, N. Kased, S. W. Kwan, A. C. Gamst, A. C. Santosa, T. Hassanein, and C. B. Sirlin Double-Contrast MRI for Accurate Staging of Hepatocellular Carcinoma in Patients with Cirrhosis Am. J. Roentgenol., January 1, 2008; 190(1): 47 - 57. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. N. Gandhi, M. A. Brown, J. G. Wong, D. A. Aguirre, and C. B. Sirlin MR Contrast Agents for Liver Imaging: What, When, How RadioGraphics, November 1, 2006; 26(6): 1621 - 1636. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
P J A Robinson EBM and the diagnosis of hepatocellular carcinoma Br. J. Radiol., April 1, 2005; 78(928): 370 - 371. [Full Text] [PDF]
|
|
|
|
 |
|
 D. V. Sahani and S. P. Kalva Imaging the Liver Oncologist, July 1, 2004; 9(4): 385 - 397. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. J. Pijl, J. Doornbos, M. N. J. M. Wasser, H. C. van Houwelingen, R. A. E. M. Tollenaar, and J. L. Bloem Quantitative Analysis of Focal Masses at MR Imaging: A Plea for Standardization Radiology, June 1, 2004; 231(3): 737 - 744. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. K. Kim, C. S. Kim, Y. H. Lee, H. S. Kwak, and J. M. Lee Comparison of Superparamagnetic Iron Oxide-Enhanced and Gadobenate Dimeglumine-Enhanced Dynamic MRI for Detection of Small Hepatocellular Carcinomas Am. J. Roentgenol., May 1, 2004; 182(5): 1217 - 1223. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-J. Kim, J. H. Kim, J.-J. Chung, M. S. Park, J. S. Lim, and Y. T. Oh Focal Hepatic Lesions: Detection and Characterization with Combination Gadolinium- and Superparamagnetic Iron Oxide-enhanced MR Imaging Radiology, September 1, 2003; 228(3): 719 - 726. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Ward, J. A. Guthrie, D. Wilson, P. Arnold, J. P. Lodge, G. J. Toogood, J. I. Wyatt, and P. J. Robinson Colorectal Hepatic Metastases: Detection with SPIO-enhanced Breath-hold MR Imaging—Comparison of Optimized Sequences Radiology, September 1, 2003; 228(3): 709 - 718. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. E. Steingruber, A. Mallouhi, B. V. Czermak, P. Waldenberger, E. Gassner, F. Offner, A. Chemelli, A. Koenigsrainer, W. Vogel, and W. R. Jaschke Pretransplantation Evaluation of the Cirrhotic Liver with Explantation Correlation: Accuracy of CT Arterioportography and Digital Subtraction Hepatic Angiography in Revealing Hepatocellular Carcinoma Am. J. Roentgenol., July 1, 2003; 181(1): 99 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Bhartia, J. Ward, J. A. Guthrie, and P. J. Robinson Hepatocellular Carcinoma in Cirrhotic Livers: Double-Contrast Thin-Section MR Imaging with Pathologic Correlation of Explanted Tissue Am. J. Roentgenol., March 1, 2003; 180(3): 577 - 584. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Mori, J. Scheidler, T. Helmberger, N. Holzknecht, R. Schauer, C. A. Schirren, I. Bittmann, M. Dugas, and M. Reiser Detection of Malignant Hepatic Lesions Before Orthotopic Liver Transplantation: Accuracy of Ferumoxides-Enhanced MR Imaging Am. J. Roentgenol., October 1, 2002; 179(4): 1045 - 1051. [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]
|
|
|
|
|
|
E. Caturelli, M. Pompili, F. Bartolucci, D. A. Siena, M. Sperandeo, A. Andriulli, and M. Bisceglia Hemangioma-like Lesions in Chronic Liver Disease: Diagnostic Evaluation in Patients Radiology, August 1, 2001; 220(2): 337 - 342. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Krinsky, V. S. Lee, N. D. Theise, J. C. Weinreb, N. M. Rofsky, T. Diflo, and L. W. Teperman Hepatocellular Carcinoma and Dysplastic Nodules in Patients with Cirrhosis: Prospective Diagnosis with MR Imaging and Explantation Correlation Radiology, May 1, 2001; 219(2): 445 - 454. [Abstract] [Full Text]
|
|
|
|
|
|
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]
|
|
