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Characterization of Liver Lesions with Mangafodipir Trisodium–enhanced MR Imaging: Multicenter Study Comparing MR and Dual-Phase Spiral CT¹

¹ From the Dept of Radiology, Daniel den Hoed Cancer Ctr, Univ Hosp Rotterdam, the Netherlands (M.O., B.S., P.v.D.); State Univ and Academic Hosp of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB Groningen, the Netherlands (M.O., J.C.d.G.); First Univ Hosp, West China Univ of Med Sciences, Chengdu, People’s Republic of China (B.S.); Nycomed Amersham, Oslo, Norway (C.G.T.), and Munich, Germany (M.M.); Ruhr Univ Clinic, Bochum, Germany (M.K.); Christian-Albrechts Univ, Kiel, Germany (J.G.); Hosp La Paz, Madrid, Spain (J.F.C.); and Univ Hospital, Free Univ Brussels, Belgium (B.O.d.B.). From the 1999 RSNA scientific assembly. Received Jan 16, 2001; revision requested Mar 5; final revision received Oct 4; accepted Oct 15. Address correspondence to M.O. (e-mail: m.oudkerk@rad.azg.nl).

PURPOSE: To evaluate whether mangafodipir trisodium (Mn-DPDP)–enhanced magnetic resonance (MR) imaging surpasses dual-phase spiral computed tomography (CT) in differentiating focal liver lesions.

MATERIALS AND METHODS: One hundred forty-five patients who had or were suspected of having focal liver lesions were included in a multicenter study and underwent dual-phase spiral CT and enhanced MR imaging. Image interpretations performed by independent experienced radiologists were compared with the final diagnosis that was based on all available clinical information (including histopathologic findings in 77 patients) and that was determined with consensus. Differences in classifications by using either enhanced MR imaging or dual-phase spiral CT were analyzed with the McNemar test, and receiver operating characteristic (ROC) curves were used to compare the diagnostic performance of enhanced MR imaging and dual-phase spiral CT.

RESULTS: Lesion classification was correct in 108 (74%) patients with enhanced MR imaging and in 83 (57%) with dual-phase spiral CT (P = .001). Lesions were correctly classified as either malignant or benign in 123 (85%) patients with enhanced MR imaging and in 98 (68%) with dual-phase spiral CT (P = .001). Classification of lesions as either hepatocellular or nonhepatocellular was correct in 130 (90%) patients with enhanced MR imaging and in 93 (64%) with dual-phase spiral CT (P = .001). These differences remained when analyses were restricted to histopathologically confirmed diagnoses. Comparison of the ROC curves illustrated that enhanced MR imaging performance surpassed that of dual-phase spiral CT.

CONCLUSION: Mn-DPDP–enhanced MR imaging is superior to dual-phase spiral CT in classification of focal liver lesions.

© RSNA, 2002

Index terms: Computed tomography (CT), comparative studies, 761.12115 • Contrast media • Liver neoplasms, diagnosis, 761.312, 761.3192, 761.3194, 761.3198, 761.32, 761.323, 761.33 • Magnetic resonance (MR), comparative studies, 761.12143

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