The purpose of our study was to determine whether or not the addition of T2-weighted fast spin-echo (SE) imaging to
gadolinium-enhanced spoiled gradient-recalled-echo (GRE) imaging improves the observer performance in the preoperative detection of malignant hepatic
tumors.
Gadolinium-enhanced GRE and fat-suppressed T2-weighted fast SE images obtained in 49 patients with 82 surgically confirmed malignant hepatic
tumors (40
hepatocellular carcinomas and 42
metastases) were retrospectively reviewed by three independent off-site observers. In the random review of images,
gadolinium-enhanced GRE images were reviewed first; thereafter, T2-weighted fast SE images were added for combined review. Observer performance was evaluated with the McNemar's test and receiver operating characteristic curve analysis. For
gadolinium-enhanced GRE images alone vs. combined images, sensitivities for detection were 78% vs. 79% for
hepatocellular carcinomas (P>.05), 67% vs. 71% for
metastases (P<.05) and 72% vs. 75% for
tumors overall (P<.05), respectively. The Az values were 0.892 vs. 0.889 in
hepatocellular carcinomas (P>.05), 0.797 vs. 0.828 in
metastases (P<.05) and 0.839 vs. 0.846 in
tumors overall (P>.05), respectively. Our results showed that the addition of T2-weighted fast SE imaging to
gadolinium-enhanced GRE imaging improved the observer performance in the detection of
metastases.