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Malignant hepatic tumor detection with ferumoxide‐enhanced magnetic resonance imaging: Is chemical‐shift‐selective fat suppression necessary for fast spin‐echo sequence?
Author(s) -
Goshima Satoshi,
Kanematsu Masayuki,
Matsuo Masayuki,
Kondo Hiroshi,
Kako Nobuo,
Yokoyama Ryujiro,
Hoshi Hiroaki,
Moriyama Noriyuki
Publication year - 2004
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.20091
Subject(s) - magnetic resonance imaging , fast spin echo , medicine , receiver operating characteristic , spin echo , nuclear medicine , t2 weighted , sequence (biology) , mcnemar's test , hccs , radiology , hepatocellular carcinoma , nuclear magnetic resonance , chemistry , physics , mathematics , biochemistry , statistics
Purpose To determine whether chemical‐shift‐selective (CSS) fat suppression is necessary for ferumoxide‐enhanced T2‐weighted fast spin‐echo (FSE) imaging in the detection of malignant hepatic tumors. Materials and Methods Ferumoxide‐enhanced magnetic resonance (MR) images obtained in 38 patients with surgically confirmed 61 malignant hepatic tumors (36 hepatocellular carcinomas (HCCs), 25 metastases) were retrospectively reviewed by three independent readers. Three sequences of MR images with CSS fat‐suppressed T2‐weighted FSE, non‐fat‐suppressed T2‐weighted FSE, and T2*‐weighted gradient‐recalled‐echo (GRE) sequences were randomly reviewed on a segment‐by‐segment basis in a blind fashion. Observer performance was tested using the McNemar's test and receiver‐operating‐characteristic (ROC) analysis for the clustered data. Lesion‐to‐liver contrast‐to‐noise ratio (C/N) was also assessed. Results The mean C/N with the CSS fat‐suppressed FSE sequence was highest in HCCs, metastases, and tumors overall. Sensitivity was highest with the CSS fat‐suppressed FSE sequence in HCC, was highest with the non‐fat‐suppressed FSE sequence in metastases, and was comparable in tumors overall. Specificity was comparable between the sequences. The area under ROC curve ( Az ) value was greatest with the CSS fat‐suppressed FSE sequence in HCCs, was greatest with the non‐fat‐ suppressed FSE sequence in metastases, and was comparable in tumors overall. The sensitivities and Az values were lower with the GRE sequence than the FSE sequence. Conclusion The CSS fat‐suppressed FSE sequence was superior to the GRE sequence in the detection of HCCs, but the non‐fat‐suppressed FSE sequence was comparable to the GRE sequence. The non‐fat‐suppressed FSE sequence was superior to the CSS fat‐suppressed FSE and GRE sequences in the detection of metastases. Optimal FSE imaging with CSS fat suppression or without aiming for the detection of HCCs or metastases, respectively, outperforms GRE imaging in ferumoxide‐enhanced MRI. J. Magn. Reson. Imaging 2004;20:75–82. © 2004 Wiley‐Liss, Inc.