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: 2383041825v1 239/1/131    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 Onishi, H. Articles by Nakamura, H. Search for Related Content PubMed PubMed Citation Articles by Onishi, H. Articles by Nakamura, H.

Hepatic Metastases: Detection with Multi–Detector Row CT, SPIO-enhanced MR Imaging, and Both Techniques Combined¹

¹ From the Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan (H.O., T.M., T.K., M.H., M.K., H.A., S.N., K.O., K.T., H.N.); and Department of Radiological Sciences, University of Rome-La Sapienza, Rome, Italy (R.I., R.P.). Received October 25, 2004; revision requested December 29; revision received February 24, 2005; accepted March 15; final version accepted, May 5. Address correspondence to T.M., Department of Diagnostic and Interventional Radiology, Kinki University School of Medicine, 377-2, Ohno-higashi, Osakasayama, Osaka 589-8511, Japan (e-mail: murakami{at}med.kindai.ac.jp).

Purpose: To retrospectively compare the accuracy in detection of hepatic metastases among contrast material–enhanced multi–detector row computed tomography (CT) alone, superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging alone, and a combination of contrast-enhanced CT and SPIO-enhanced MR imaging.

Materials and Methods: The ethics committee did not require its approval or informed consent for this retrospective study, which was compliant with Declaration of Helsinki principles. Data in 38 patients (22 men, 16 women; mean age, 64.5 years; range, 35–78 years) suspected of having hepatic metastases who underwent both contrast-enhanced CT and SPIO-enhanced MR imaging were retrospectively analyzed. Twenty-one of the 38 patients had 61 metastases. Seventeen of the 61 metastases were confirmed histologically; the remaining 44 metastases were defined with imaging follow-up. At MR imaging, SPIO-enhanced heavily T1-weighted images, T2*-weighted gradient echo images, and T2-weighted fast spin-echo images were evaluated. Contrast-enhanced multi–detector row CT images obtained in the portal phase were evaluated. Four blinded observers independently reviewed CT images, MR images, and the combination of CT and MR images. Diagnostic accuracy was evaluated by using the alternative free-response receiver operating characteristic (AFROC) method. Sensitivities and positive predictive values were also analyzed with the Fisher protected least significant difference test and generalized estimating equations.

Results: The mean area under the AFROC curve for the combined approach (0.70) was significantly higher than that for SPIO-enhanced MR imaging alone (0.58, P < .05, Fisher protected least significant difference test), and there was no significant difference between each of them and that for contrast-enhanced CT alone (0.66). For all lesions, the mean sensitivity of combined imaging (0.59) was significantly higher than that of CT (0.48) or MR imaging (0.43) alone (P < .05, Fisher protected least significant difference test and generalized estimating equations). For all lesions, the mean positive predictive values were 0.82, 0.89, and 0.81, for combined MR and CT, CT alone, and MR alone, respectively.

Conclusion: The addition of SPIO-enhanced MR imaging to contrast-enhanced multi–detector row CT (ie, combined analysis of SPIO-enhanced MR images and contrast-enhanced CT images) can improve sensitivity in the detection of hepatic metastases, although this improvement in sensitivity was not significant at AFROC analysis.

© RSNA, 2006

This article has been cited by other articles:

				Y. S. Maetani, H. Isoda, A. Nomura, S. Arizono, Y. Hirokawa, T. Shibata, and T. Kaori CT Laparoscopy for Detecting Small Superficial Metastatic Lesions of the Liver Surface: Initial Experience Am. J. Roentgenol., May 1, 2008; 190(5): 1314 - 1317. [Abstract] [Full Text] [PDF]

				H. Furukawa, K. Uesaka, and N. Boku Treatment Decision Making in Pancreatic Adenocarcinoma: Multidisciplinary Team Discussion With Multidetector-Row Computed Tomography Arch Surg, March 1, 2008; 143(3): 275 - 280. [Abstract] [Full Text] [PDF]