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Figure 3b: Liver metastasis from rectal cancer in 59-year-old man. At follow-up CT 1 month later, the lesion showed growth and the tumor marker increased during the observation period. Hence, the lesion was considered to be a true metastatic tumor. (a) Transverse contrast-enhanced CT scan shows the lesion as a small hypoattenuating area (arrow). (b) Transverse SPIO-enhanced fast low-angle shot MR image (150/10; flip angle, 60°) shows the lesion as a triangular hyperintense nodule (arrow). With CT images alone, three readers assigned a confidence score of 2 to this lesion and the remaining reader assigned a score of 3. With MR images alone, three readers assigned a score of 0 and the remaining reader assigned a score of 1. With both CT and MR images, one reader assigned a score of 1, two readers assigned a score of 2, and the remaining reader assigned a score of 3. On MR images alone, it was difficult to distinguish the true lesion from vessels because the lesion appeared as a triangular rather than a round shape and mimicked the obliquely sectioned vessel.
