HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2283020376v1 228/3/709    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ward, J. Articles by Robinson, P. J. Search for Related Content PubMed PubMed Citation Articles by Ward, J. Articles by Robinson, P. J.

Colorectal Hepatic Metastases: Detection with SPIO-enhanced Breath-hold MR Imaging—Comparison of Optimized Sequences¹

¹ From the Department of Clinical Radiology (J.W., J.A.G., D.W., P.A., P.J.R.), Hepatobiliary and Transplantation Unit (J.P.L., G.J.T.), and Department of Histopathology (J.I.W.), St James’s University Hospital, Beckett St, Leeds LS9 7TF, England. Received March 28, 2002; revision requested June 10; final revision received December 18; accepted January 23, 2003. Address correspondence to J.W. (e-mail: janice.ward@leedsth.nhs.uk).

PURPOSE: To compare the accuracy of four breath-hold magnetic resonance (MR) imaging sequences to establish the most effective superparamagnetic iron oxide (SPIO)–enhanced sequence for detection of colorectal hepatic metastases.

MATERIALS AND METHODS: Thirty-one patients with colorectal hepatic metastases underwent T1-weighted gradient-echo (GRE) and T2-weighted fast spin-echo (FSE) MR imaging before and after SPIO enhancement. Four sequences were optimized for lesion detection: T2-weighted FSE, multiecho data image combination (MEDIC), T2-weighted GRE with an 11-msec echo time (TE), and T2-weighted GRE with a 15-msec TE. Images were reviewed independently by three blinded observers. The accuracy of each sequence was measured by using alternative free-response receiver operating characteristic analysis. All results were correlated with findings at surgery, intraoperative ultrasonography, or histopathologic examination. Differences between the mean results of the three observers were measured by using the Student t test.

RESULTS: Postcontrast T2-weighted GRE sequences were the most accurate and were significantly superior to postcontrast T2-weighted FSE and unenhanced sequences alone (P < .05). For all lesions that were malignant or smaller than 1 cm, respectively, mean accuracies of postcontrast sequences were 0.082 and 0.64 for T2-weighted FSE, 0.90 and 0.78 for MEDIC, 0.92 and 0.80 for GRE with an 11-msec TE, 0.93 and 0.82 for GRE with a 15-msec TE, and 0.81 and 0.62 for unenhanced sequences.

CONCLUSION: Optimized SPIO-enhanced T2-weighted GRE combined with unenhanced T2-weighted FSE MR sequences were the most sensitive. Breath-hold FSE postcontrast sequences offer no improvement in sensitivity compared with unenhanced sequences alone.

© RSNA, 2003

Index terms: Iron • Liver neoplasms, metastases, 761.33 • Liver neoplasms, MR, 761.121411, 761.121412, 761. 121415, 761.121417, 761.12143 • Magnetic resonance (MR), comparative studies, 761.121411, 761.121412, 761. 121415, 761.121417, 761.12143 • Magnetic resonance (MR), contrast enhancement, 761.12143 • Magnetic resonance (MR), contrast media, 761.12143

This article has been cited by other articles:

				C. Charnsangavej, B. Clary, Y. Fong, A. Grothey, T. M. Pawlik, and M. A. Choti Selection of Patients for Resection of Hepatic Colorectal Metastases: Expert Consensus Statement Ann. Surg. Oncol., October 1, 2006; 13(10): 1261 - 1268. [Full Text] [PDF]

				M.-J. Kim, J. H. Kim, J. Y. Choi, S. H. Park, J.-J. Chung, K. W. Kim, and D. G. Mitchell Optimal TE for SPIO-enhanced gradient-recalled echo MRI for the detection of focal hepatic lesions. Am. J. Roentgenol., September 1, 2006; 187(3): W255 - W266. [Abstract] [Full Text] [PDF]

				J. Ward, P. J. Robinson, J. A. Guthrie, S. Downing, D. Wilson, J. P. A. Lodge, K. R. Prasad, G. J. Toogood, and J. I. Wyatt Liver Metastases in Candidates for Hepatic Resection: Comparison of Helical CT and Gadolinium- and SPIO-enhanced MR Imaging Radiology, October 1, 2005; 237(1): 170 - 180. [Abstract] [Full Text] [PDF]

				S. Bipat, M. S. van Leeuwen, E. F. I. Comans, M. E. J. Pijl, P. M. M. Bossuyt, A. H. Zwinderman, and J. Stoker Colorectal Liver Metastases: CT, MR Imaging, and PET for Diagnosis--Meta-analysis Radiology, October 1, 2005; 237(1): 123 - 131. [Abstract] [Full Text] [PDF]

				P Manoharan and J Ward MRI in the assessment of focal liver lesions in the non-cirrhotic patient Imaging, September 1, 2004; 16(4): 338 - 350. [Abstract] [Full Text] [PDF]