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Gastrointestinal Imaging |
1 From the Department of Diagnostic Radiology, Research Institute of Radiological Science, Severance Hospital (M.J.K., J.H.K., J.J.C., J.S.L., Y.T.O.), Brain Korea 21 Project for Medical Science (M.J.K.), and Department of Diagnostic Radiology, Yong Dong Severance Hospital (M.S.P.), Yonsei University College of Medicine, Seodaemun-ku, Shinchon-dong 134, Seoul 120-752, Republic of Korea; and Department of Diagnostic Radiology, NHIC Ilsan Hospital, Gyonggi-do, Korea (J.J.C.). Received June 18, 2002; revision requested August 20; final revision received December 29; accepted January 20, 2003. Address correspondence to M.J.K. (e-mail: kimnex@yumc.yonsei.ac.kr).
PURPOSE: To compare gadolinium- and superparamagnetic iron oxide (SPIO)–enhanced magnetic resonance (MR) imaging for detection and characterization of focal hepatic lesions when different contrast agent administration sequences are used.
MATERIALS AND METHODS: Unenhanced, dynamic gadolinium-enhanced, and SPIO-enhanced hepatic MR images were obtained in 134 patients. SPIO-enhanced MR imaging was performed immediately after gadolinium-enhanced dynamic MR imaging in 50 patients, 1 day after gadolinium-enhanced dynamic MR imaging in 40 patients, and before gadolinium-enhanced dynamic MR imaging in 44 patients. Two radiologists independently reviewed the gadolinium image set (unenhanced and gadolinium-enhanced dynamic MR images) and the SPIO image set (unenhanced and SPIO-enhanced MR images) in random order. Lesion detection sensitivity and lesion characterization accuracy were compared by analyzing the area under the receiver operating characteristic curve (Az).
RESULTS: Overall lesion detection accuracy for pooled data was significantly higher with the SPIO set (Az = 0.903) than with the gadolinium set (Az = 0.857) (P < .05). When hypovascular lesions were excluded, the detection rate was similar with the two sets. When hepatocellular carcinomas were excluded, the detection rate was significantly higher with the SPIO set (P < .01). Readers were more accurate in differentiating benign from malignant lesions with the gadolinium set (Az = 0.915) than with the SPIO set (Az = 0.847) (P < .01). Detection accuracy tended to be better with the images obtained after the second contrast agent was used.
CONCLUSION: Hypovascular lesion detection was better with SPIO-enhanced MR images than with gadolinium-enhanced MR images. Detection and characterization of hypervascular lesions were improved with gadolinium-enhanced MR images.
© RSNA, 2003
Index terms: Contrast media, comparative studies • Gadolinium • Iron • Liver neoplasms, diagnosis, 761.3121, 761.3199, 761.323, 761.33 • Liver neoplasms, MR, 761.12143 • Magnetic resonance (MR), contrast media
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