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Cervical Lymph Node Metastases: MR Imaging of Gadofluorine M and Monocrystalline Iron Oxide Nanoparticle–47 in a Rabbit Model of Head and Neck Cancer¹

¹ From the Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea (S.H.C., M.H.H., W.K.M., K.R.S., J.H.K., B.J.K., D.G.N., K.H.C.); Department of Pathology, Seoul National University Hospital, Seoul, Korea (J.K.W.); and Department of Contrast Media Research, Schering, Berlin, Germany (H.J.W.). Received December 7, 2005; revision requested January 27, 2006; revision received February 8; final version accepted March 22. Supported by a grant from the Seoul National University Hospital Research Fund (04-2005-075-0). Address correspondence to M.H.H. (e-mail: hanmh{at}radcom.snu.ac.kr).

Purpose: To prospectively compare the accuracy of gadofluorine M with that of monocrystalline iron oxide nanoparticle (MION)-47 for the depiction of cervical lymph node metastases at magnetic resonance (MR) imaging in a rabbit model of head and neck cancer by using histologic analysis as the reference standard.

Materials and Methods: Experiments were approved by the animal care committee. VX2 carcinomas were implanted in both ears of 11 rabbits 4 weeks before MR imaging. T2-weighted, T2*-weighted, and T1-weighted MR images were acquired, and sequential T1-weighted MR imaging was performed immediately and 30 minutes after administration of gadofluorine M (0.05 mmol gadolinium per kilogram body weight). T2-weighted and T2*-weighted MR imaging were performed 24 hours after administration of MION-47 (2.6 mg iron per kilogram body weight). Gadofluorine M– and MION-47–enhanced MR imaging were performed separately and independently by two radiologists who had no knowledge of histopathologic results, and the presence of metastases in lymph nodes was evaluated. A receiver operating characteristic analysis was conducted to compare the diagnostic value of gadofluorine M– and MION-47–enhanced MR imaging.

Results: Metastases were confirmed in 20 of 77 lymph nodes at histopathologic analysis. The area under the curve was significantly greater for gadofluorine M–enhanced MR imaging (0.997 and 0.981 for readers 1 and 2, respectively) than for MION-47–enhanced MR imaging (0.889 and 0.846 for readers 1 and 2, respectively). For gadofluorine M–enhanced MR imaging, sensitivity was 100% for both readers and specificity was 89.5% for reader 1 and 87.7% for reader 2. For MION-47–enhanced MR imaging, sensitivity was 80.0% for both readers and specificity was 75.4% for reader 1 and 71.9% for reader 2.

Conclusion: Gadofluorine M–enhanced MR imaging has higher accuracy for depicting lymph node metastases than does MION-47–enhanced MR imaging.

© RSNA, 2006

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