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Diagnostic value of SPIO-mediated breath-hold, black-blood, fluid-attenuated, inversion recovery (BH-BB-FLAIR) imaging in patients with hepatocellular carcinomas.

AbstractPURPOSE:
We assessed the value of adding a breath-hold, black-blood, fluid-attenuated, inversion recovery (BH-BB-FLAIR) sequence with a small motion-probing gradient (b=10 s/mm(2)) using superparamagnetic iron oxide (SPIO) to our present studies that utilize SPIO to detect hepatocellular carcinoma (HCC). We used inversion recovery (IR) in a FLAIR sequence to suppress signals from cysts and a low b-value to suppress vessel signals and provide higher signal to noise than that using high b-value diffusion-weighted imaging. Use of SPIO is expected to reduce the signal in both normal liver parenchyma and in most benign lesions.
MATERIALS AND METHODS:
In 19 patients, we reviewed 38 HCC nodules diagnosed by CT arterioportography (CTAP) and CT during hepatic arteriography (CTHA). We divided SPIO-mediated images into sets, those obtained with and without BH-BB-FLAIR. Six radiologists individually interpreted the 2 image sets and sorted them by their confidence levels for the presence of HCC, and we calculated the area under the receiver operating characteristic (ROC) curve (Az) for each image set.
RESULTS:
On images obtained with BH-BB-FLAIR after SPIO administration, 33 of the 38 HCC nodules appeared as areas of high signal and cyst signal was extinguished. The ROC analysis showed significantly higher Az values in the set with BH-BB-FLAIR (0.89) than in the set without (0.83).
CONCLUSIONS:
Adding BH-BB-FLAIR to existing SPIO-mediated imaging protocols improved detection of HCC nodules and added only 24 s to the scan time.
AuthorsMasaya Matsushima, Shinji Naganawa, Mitsuru Ikeda, Shigeki Itoh, Hiroshi Ogawa, Tomohiro Komada, Satoko Ishigaki, Hisashi Kawai, Koujiro Suzuki, Hiroko Satake, Shingo Iwano
JournalMagnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine (Magn Reson Med Sci) Vol. 9 Issue 2 Pg. 49-58 ( 2010) ISSN: 1880-2206 [Electronic] Japan
PMID20585194 (Publication Type: Journal Article)
Chemical References
  • Ferric Compounds
  • ferric oxide
Topics
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Angiography (methods)
  • Area Under Curve
  • Carcinoma, Hepatocellular (diagnosis, diagnostic imaging, pathology)
  • Cysts (diagnostic imaging, pathology)
  • Diffusion Magnetic Resonance Imaging (methods)
  • Ferric Compounds
  • Humans
  • Liver (diagnostic imaging, pathology)
  • Magnetic Resonance Imaging (methods)
  • Male
  • Middle Aged
  • ROC Curve
  • Respiration
  • Time Factors
  • Tomography, X-Ray Computed

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