Detection of Hepatocellular Carcinoma with Ferucarbotran (Resovist)-enhanced Breath-hold MR Imaging: Feasibility of 10 minute-delayed Images

• Published in: Magnetic Resonance in Medical Sciences Vol. 7; no. 3; pp. 123 - 130
• Main Authors: SAITO, Kazuhiro, SHINDO, Hiroaki, OZUKI, Taizo, ISHIKAWA, Aimi, KOTAKE, Fumio, SHIMAZAKI, Yoko, ABE, Kimihiko
• Format: Journal Article
• Language: English
• Published: Japan Japanese Society for Magnetic Resonance in Medicine 2008
• Subjects: Aged; Aged, 80 and over; Carcinoma, Hepatocellular - diagnosis; Contrast Media; Dextrans; Feasibility Studies; Female; Ferrosoferric Oxide; hepatocellular carcinoma; Humans; Image Enhancement - methods; Iron; Liver Neoplasms - diagnosis; Magnetic Resonance Imaging - methods; Magnetite Nanoparticles; Male; Middle Aged; MRI; optimal timing; Oxides; Reproducibility of Results; Respiratory Mechanics; Sensitivity and Specificity; superparamagnetic iron oxide; Time Factors
• ISSN: 1347-3182; 1880-2206
• DOI: 10.2463/mrms.7.123

Purpose: We evaluated the optimal timing for breath-hold MR imaging with bolus-injectable superparamagnetic iron oxide (SPIO) for detecting hepatocellular carcinoma (HCC). Materials and Methods: Twenty patients with 62 HCCs (52 hypervascular, 10 non-hypervascular) underwent MR imaging that included unenhanced and SPIO-enhanced T1-weighted gradient echo (GRE) and T2-weighted fast spin echo (FSE) sequences, perfusion study, and SPIO-enhanced T2*-weighted GRE sequences. We obtained SPIO-enhanced T2*-weighted sequences 10 and 30 min after injecting SPIO and made 2 image sets, comprising 10- or 30-min delayed T2*-weighted images. Three observers performed alternative free response receiver operating characteristic (AFROC) analysis, and quantitative evaluation was performed. Results: Only Observers 2 and 3 recognized a significant difference in the area under the AFROC curve (Az) value in the 10-min delayed images; no significant difference was observed in the 30-min delayed images. There was no significant difference in the sensitivity of individual observers between 10- and 30-min delayed images. The contrast-to-noise (C/N) ratio of the 30-min delayed images was significantly higher than that of the 10-min delayed images. The C/N ratio of hypervascular HCCs in the 30-min delayed images was significantly higher than in the 10-min delayed images, but that of non-hypervascular HCCs showed no significant difference. Conclusion: In most cases, 10-min delayed SPIO-enhanced T2*-weighted images are sufficient to detect HCCs.