Multidetector helical CT plus superparamagnetic iron oxide-enhanced MR imaging for focal hepatic lesions in cirrhotic liver: A comparison with multi-phase CT during hepatic arteriography

• Published in: European journal of radiology Vol. 61; no. 2; pp. 279 - 289
• Main Authors: Yukisawa, Seigo, Okugawa, Hidehiro, Masuya, Yoshio, Okabe, Shinichirou, Fukuda, Hiroyuki, Yoshikawa, Masaharu, Ebara, Masaaki, Saisho, Hiromitsu
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.02.2007; Elsevier Science
• Subjects: Biological and medical sciences; Carcinoma, Hepatocellular - diagnosis; Cardiovascular system; Contrast Media; CT-angiography; Dextrans; Ferrosoferric Oxide; Gastroenterology. Liver. Pancreas. Abdomen; Hepatocellular carcinoma; Humans; Investigative techniques, diagnostic techniques (general aspects); Iron; Liver; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - pathology; Liver Neoplasms - diagnosis; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Magnetic Resonance Imaging - methods; Magnetite Nanoparticles; Medical sciences; MR-imaging; Observer Variation; Other diseases. Semiology; Oxides; Portography - methods; Predictive Value of Tests; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiology; Retrospective Studies; ROC Curve; Superparamagnetic iron oxide; Tomography, X-Ray Computed - methods; Tumors; CT; Hepatocellular carcinoma; MR-imaging; Liver; CT-angiography; Superparamagnetic iron oxide; Focal lesion; Drug combination; Radiodiagnosis; Angiography; Hepatic disease; Helical computed tomography; Malignant tumor; Nuclear magnetic resonance imaging; Cirrhosis; Multidetector scanner; Digestive diseases; Medical imagery; Arteriography; Comparative study
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2006.09.011

Abstract The aim of this study was to evaluate multidetector helical computed tomography (MDCT), superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging, and CT arterial portography (CTAP) and CT during hepatic arteriography (CTHA) for the detection and diagnosis of hepatocellular carcinomas (HCC). This included visual correlations of MDCT and SPIO-MR imaging in the detection of HCC using receiver operating characteristic (ROC) analysis. Twenty-five patients with 57 nodular HCCs were retrospectively analyzed. A total of 200 segments, including 49 segments with 57 HCCs, were reviewed independently by three observers. Each observer read four sets of images (set 1, MDCT; set 2, unenhanced and SPIO-enhanced MR images; set 3, combined MDCT and SPIO-enhanced MR images; set 4, combined CTAP and CTHA). The mean Az values representing the diagnostic accuracy for HCCs of sets 1, 2, 3, and 4 were 0.777, 0.814, 0.849, and 0.911, respectively, and there was no significant difference between sets 3 and 4. The sensitivity of set 4 was significantly higher than those of set 3 for all the lesions and for lesions 10 mm or smaller ( p < 0.05); however, for lesions larger than 10 mm, the sensitivities of the two sets were similar. No significant difference in positive predictive value and specificity was observed between set 3 and set 4. Combined MDCT and SPIO-enhanced MR imaging may obviate the need for more invasive CTAP and CTHA for the pre-therapeutic evaluation of patients with HCC more than 10 mm.