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Detection of Liver Metastases: Comparison of Gadobenate Dimeglumine–enhanced and Ferumoxides-enhanced MR Imaging Examinations¹

¹ From the Institute of Radiology, Udine University, Policlinico Universitario a Gestione diretta, via Colugna 50, 33100 Udine, Italy (C.D.F., M.B., C.Z., V.L., G.C., R.Z.); and Department of Radiology, Brigham and Women’s Hospital, Boston, Mass (K.J.M., P.R.R.). From the 2000 RSNA scientific assembly. Received November 20, 2001; revision requested December 19; revision received February 18, 2002; accepted April 16. Address correspondence to C.D.F. (e-mail: iaiacdf@hotmail.com).

PURPOSE: To compare gadobenate dimeglumine (Gd-BOPTA)–enhanced magnetic resonance (MR) imaging with ferumoxides-enhanced MR imaging for detection of liver metastases.

MATERIALS AND METHODS: Twenty consecutive patients known to have malignancy and suspected of having focal liver lesions at ultrasonography (US) underwent 1.0-T MR imaging with gradient-recalled-echo T1-weighted breath-hold sequences before, immediately after, and 60 minutes after Gd-BOPTA injection. Subsequently, MR imaging was performed with turbo spin-echo short inversion time inversion-recovery T2-weighted sequences before and 60 minutes after ferumoxides administration. All patients subsequently underwent intraoperative US within 15 days, and histopathologic analysis of their resected lesion-containing specimens was performed. Separate qualitative analyses were performed to assess lesion detection with each contrast agent. Quantitative analyses were performed by measuring signal-to-noise and contrast-to-noise ratios (CNRs) on pre- and postcontrast Gd-BOPTA and ferumoxides MR images. Statistical analyses were performed with Wilcoxon signed rank and Monte Carlo tests.

RESULTS: Sensitivity of ferumoxides-enhanced MR imaging was superior to that of Gd-BOPTA–enhanced MR imaging for liver metastasis detection (P < .05). Ferumoxides MR images depicted 36 (97%) of 37 metastases detected at intraoperative US, whereas Gd-BOPTA MR images depicted 30 (81%) metastases during delayed phase and 20 (54%) during dynamic phase. All six metastases identified only at ferumoxides-enhanced MR imaging were 5–10 mm in diameter. There was a significant increase in CNR between the lesion and liver before and after ferumoxides administration (from 3.8 to 6.8, P < .001) but not before or after Gd-BOPTA injection (from -4.8 to -5.5, P > .05).

CONCLUSION: Ferumoxides-enhanced MR imaging seems to be superior to Gd-BOPTA–enhanced MR imaging for liver metastasis detection.

© RSNA, 2002

Index terms: Gadolinium • Iron • Liver, MR, 761.121411, 761.121412, 761.121413, 761.121416, 761.12143 • Liver neoplasms, metastases, 761.33 • Liver neoplasms, MR, 761.121411, 761.121412, 761.121413, 761.121416, 761.12143 • Magnetic resonance (MR), contrast media, 761.12143

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