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Gastrointestinal Imaging |
1 From the Department of Radiology, Städtisches Klinikum Karlsruhe, Moltkestrasse 90, D-76133 Karlsruhe, Germany (P.R.); the Department of Clinical Radiology, Westfälische Wilhelms-Universität Münster, Germany (N.J., M.F.); the Department of Radiology, University of Vienna, Austria (W.S.); the Department of Radiology, Universitair Ziekenhuis Antwerpen, Edegem, Belgium (F.D.); the Department of Radiology, Knappschafts-Krankenhaus Bochum-Langendreer-Universitätsklinik, Germany (C.M.); the Department of Diagnostic Radiology, Klinikum Grosshadern, Munich, Germany (N.H.); and the Department of Radiology, Division of Abdominal and Interventional Radiology, Massachusetts General Hospital, Boston (S.S.). Received August 12, 1999; revision requested September 28; revision received January 14, 2000; accepted January 27. Address correspondence to P.R. (e-mail: reimerp@uni-muenster.de).
PURPOSE: To determine the accuracy for detection and characterization of focal hepatic lesions of nonenhanced, superparamagnetic iron oxide (SPIO)-enhanced, or a combination of nonenhanced and SPIO-enhanced MR imaging and contrast-enhanced spiral computed tomography (CT).
MATERIALS AND METHODS: Spiral CT and T2-weighted SPIO-enhanced (ferucarbotran-enhanced) MR imaging were performed in 35 patients within 2 weeks before surgery for malignant hepatic lesions. Only malignant lesions with histopathologic proof were considered. A total of 875 images with and 800 images without focal lesions were presented to five readers, who were asked to assess the presence and characterization of lesions by using a five-point confidence scale. Receiver operating characteristic analysis was performed.
RESULTS: Nonenhanced and SPIO-enhanced images together and SPIO-enhanced images alone yielded the best performance for lesion detection. No differences were found among all imaging techniques with regard to lesion characterization (benign vs malignant). The combined approach resulted in larger area under the ROC curve (Az = 0.9062) and accuracy (85.3%) (P < 0.02), as compared with SPIO-enhanced MR imaging (Az = 0.8667; accuracy, 73.1%).
CONCLUSION: SPIO-enhanced T2-weighted MR imaging was more accurate than nonenhanced T1-weighted and T2-weighted MR imaging and contrast-enhanced spiral CT for the detection of focal hepatic lesions. The combined analysis of nonenhanced and SPIO-enhanced images was more accurate in the characterization of focal hepatic lesions than was review of SPIO-enhanced images alone.
Index terms: Contrast media • Iron • Liver neoplasms, 761.319, 761.323, 761.33 • Liver neoplasms, MR, 761.121411, 761.121412, 761.12143 • Magnetic resonance (MR), contrast media, 761.12143
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