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

This Article Figures Only Full Text All Versions of this Article: 2371041444v1 237/1/170    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 Wyatt, J. I. Search for Related Content PubMed PubMed Citation Articles by Ward, J. Articles by Wyatt, J. I.

Liver Metastases in Candidates for Hepatic Resection: Comparison of Helical CT and Gadolinium- and SPIO-enhanced MR Imaging¹

¹ From the MRI Department, Clinical Radiology (J.W., P.J.R., J.A.G., S.D., D.W.), Hepatobiliary and Transplantation Unit (J.P.A.L., K.R.P., G.J.T.), and Department of Histopathology (J.I.W.), St James's University Hospital, Beckett Street, Leeds LS9 7TF, England. Received August 19, 2004; revision requested October 28; revision received December 8; accepted January 17, 2005. Address correspondence to J.W. (e-mail: janice.ward{at}leedsth.nhs.uk).

PURPOSE: To prospectively compare accuracy of dynamic contrast material–enhanced thin-section multi–detector row helical computed tomography (CT), high-spatial-resolution three-dimensional (3D) dynamic gadolinium-enhanced magnetic resonance (MR) imaging, and superparamagnetic iron oxide (SPIO)-enhanced MR imaging with optimized gradient-echo (GRE) sequence for depiction of hepatic lesions; surgery and histologic analysis were the reference standard.

MATERIALS AND METHODS: Local ethics committee approval was granted, and written informed consent was obtained. Fifty-eight patients (45 men, 13 women; age range, 47–82 years) with hepatic metastases were imaged with multi–detector row CT (3.2-mm section thickness), 3D dynamic gadolinium-enhanced MR imaging (2.5-mm effective section thickness), and SPIO-enhanced MR by using an optimized T2-weighted GRE sequence. Images were reviewed independently by two blinded observers who identified and localized lesions with a four-point confidence scale. Accuracy of each technique was measured with alternative free-response receiver operating characteristic analysis. Results were correlated with findings at surgery with intraoperative ultrasonography or histopathologic examination. Statistical differences among techniques for each observer were measured.

RESULTS: Accuracy values for each observer for all metastases (n = 215) and 1.0-cm or smaller metastases (n = 80), respectively, follow: For CT, those for reader 1 were 0.82 and 0.65; for reader 2, 0.81 and 0.68. For gadolinium-enhanced MR imaging, those for reader 1 were 0.92 and 0.79; for reader 2, 0.90 and 0.76. For SPIO-enhanced MR imaging, those for reader 1 were 0.92 and 0.83; for reader 2, 0.92 and 0.81. For all metastases for both observers, there was no significant difference between MR techniques, but both were significantly more accurate than CT (P < .01). For metastases 1.0 cm or smaller and one observer, there was no significant difference between MR techniques, but both were more accurate than CT (P < .01); for the other observer, SPIO-enhanced MR imaging was more accurate than gadolinium-enhanced MR imaging (P < .05) and CT (P < .02), but there was no significant difference between gadolinium-enhanced MR imaging and CT (P = .2).

CONCLUSION: Accuracy for gadolinium-enhanced MR imaging and SPIO-enhanced MR imaging was similar. Both techniques were significantly more accurate than CT.

© RSNA, 2005

This article has been cited by other articles:

				J. Ward, J. A. Guthrie, M. B. Sheridan, S. Boyes, J. T. Smith, D. Wilson, J. I. Wyatt, D. Treanor, and P. J. Robinson Sinusoidal Obstructive Syndrome Diagnosed With Superparamagnetic Iron Oxide-Enhanced Magnetic Resonance Imaging in Patients With Chemotherapy-Treated Colorectal Liver Metastases J. Clin. Oncol., September 10, 2008; 26(26): 4304 - 4310. [Abstract] [Full Text] [PDF]

				L. Chami, N. Lassau, D. Malka, M. Ducreux, S. Bidault, A. Roche, and D. Elias Benefits of Contrast-Enhanced Sonography for the Detection of Liver Lesions: Comparison with Histologic Findings Am. J. Roentgenol., March 1, 2008; 190(3): 683 - 690. [Abstract] [Full Text] [PDF]

				T. C. Lauenstein, K. Salman, R. Morreira, T. Heffron, J. R. Spivey, E. Martinez, P. Sharma, and D. R. Martin Gadolinium-Enhanced MRI for Tumor Surveillance Before Liver Transplantation: Center-Based Experience Am. J. Roentgenol., September 1, 2007; 189(3): 663 - 670. [Abstract] [Full Text] [PDF]

				S. Benoist, A. Brouquet, C. Penna, C. Julie, M. El Hajjam, S. Chagnon, E. Mitry, P. Rougier, and B. Nordlinger Complete Response of Colorectal Liver Metastases After Chemotherapy: Does It Mean Cure? J. Clin. Oncol., August 20, 2006; 24(24): 3939 - 3945. [Abstract] [Full Text] [PDF]