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Detection of hepatocellular carcinoma by ferumoxides‐enhanced MR imaging in cirrhosis: Incremental value of dynamic gadolinium‐enhancement
Author(s) -
Qayyum Aliya,
Thoeni Ruedi F.,
Coakley Fergus V.,
Lu Ying,
Guay Jeff P.,
Ferrell Linda D.
Publication year - 2006
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.20449
Subject(s) - gadolinium , hepatocellular carcinoma , medicine , cirrhosis , magnetic resonance imaging , nuclear medicine , radiology , chemistry , organic chemistry
Purpose: To investigate the incremental value of dynamic gadolinium‐enhancement performed immediately after ferumoxides‐enhanced magnetic resonance (MR) imaging on the detection of hepatocellular carcinoma in patients with cirrhosis. Materials and Methods: We retrospectively reviewed MR scans of 62 cirrhotic patients over a two‐year period. Sequences included ferumoxides‐enhanced T2‐weighted fast spin echo followed by dynamic gadolinium‐enhanced T1‐weighted spoiled gradient echo. Two readers independently documented the presence of hepatocellular carcinoma on a three‐point confidence scale, without and with gadolinium‐enhanced images. The presence or absence of hepatocellular carcinoma was established by histopathology (58 patients) or follow‐up imaging (four patients) over a mean period of nine months. Results: A total of 71 hepatocellular carcinomas were found in 42 patients. There was no statistically significant difference in sensitivity for the diagnosis of hepatocellular carcinoma without vs. with gadolinium‐enhanced images (68% vs. 74% for reader 1 and 62% vs. 73% for reader 2, respectively, P > 1.3). However, both readers showed a lower mean confidence for tumor detection without vs. with gadolinium‐enhanced images (2.3 vs. 2.7 for reader 1, 2.3 vs. 2.9 for reader 2, P < 0.01). Conclusion: In our study, the addition of dynamic gadolinium‐enhancement to ferumoxides‐enhanced MR imaging did not improve hepatocellular carcinoma detection, but the addition of gadolinium‐enhancement is recommended if ferumoxides‐enhanced imaging is used because it increased reader confidence. J. Magn. Reson. Imaging 2006. © 2005 Wiley‐Liss, Inc.