Hypervascular hepatocellular carcinoma in the cirrhotic liver: diffusion-weighted imaging versus superparamagnetic iron oxide-enhanced MRI.

Abstract

PURPOSE:

The purpose of the study was to validate diffusion-weighted imaging (DWI) in the assessment of hypervascular hepatocellular carcinoma (HCC) compared with superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) in the cirrhotic liver.

MATERIAL AND METHODS:

Forty-six consecutive patients with 106 hypervascular focal lesions in the cirrhotic liver who underwent DWI using three b factors and gadopentetate dimeglumine-enhanced dynamic MRI followed by SPIO-enhanced MRI were enrolled. Two independent radiologists evaluated two separated image sets (SPIO set, dynamic MRI and SPIO-enhanced T2*-weighted images; DWI set, DWI and dynamic MRI) and assigned confidence levels for diagnosis of HCC using a five-point scale for each lesion. Area under the receiver operating characteristic curve (A(z)) was calculated for each image set.

RESULTS:

The A(z) value of the DWI set was larger than the SPIO set by both readers (reader 1, 0.936 vs. 0.900, P=.050; reader 2, 0.938 vs. 0.905, P=.110). For the sensitivity (reader 1, 93.1% vs. 86.2%, P=.146; reader 2, 95.4% vs. 88.5%, P=.070) and specificity (reader 1, 89.5% vs. 73.7%, P=.250; reader 2, 79.0% vs. 73.7%, P=1.000) of HCC diagnosis, DWI sets were superior to SPIO sets without statistically significant differences.

CONCLUSION:

For assessment of hypervascular HCC, DWI in combination with dynamic MRI provides comparable or slightly better information compared with the combination of dynamic and SPIO-enhanced MRI.

• Authors: Jin Chung, Jeong-Sik Yu, Dae Jung Kim, Jae-Joon Chung, Joo Hee Kim, Ki Whang Kim
• Journal: Magnetic resonance imaging (Magn Reson Imaging) Vol. 29 Issue 9 Pg. 1235-43 (Nov 2011) ISSN: 1873-5894 [Electronic] Netherlands
• PMID: 21907517 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• Contrast Media
• Ferric Compounds
• gadolinium ethoxybenzyl DTPA
• ferric oxide
• Gadolinium DTPA

Topics

• Carcinoma, Hepatocellular (pathology)
• Contrast Media (pharmacology)
• Diffusion Magnetic Resonance Imaging (methods)
• Ferric Compounds (pharmacology)
• Fibrosis (virology)
• Gadolinium DTPA (pharmacology)
• Humans
• Liver (pathology)
• Liver Cirrhosis (pathology)
• Liver Neoplasms (pathology)
• Magnetic Resonance Imaging (methods)
• Observer Variation
• ROC Curve
• Radiology (methods)
• Sensitivity and Specificity