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Detection of hepatocellular carcinoma (HCC) using super paramagnetic iron oxide (SPIO)‐enhanced MRI: Added value of diffusion‐weighted imaging (DWI)
Author(s) -
Nishie Akihiro,
Tajima Tsuyoshi,
Ishigami Kousei,
Ushijima Yasuhiro,
Okamoto Daisuke,
Hirakawa Masakazu,
Nishihara Yunosuke,
Taketomi Akinobu,
Hatakenaka Masamitsu,
Irie Hiroyuki,
Yoshimitsu Kengo,
Honda Hiroshi
Publication year - 2010
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.22059
Subject(s) - medicine , hepatocellular carcinoma , magnetic resonance imaging , diffusion mri , nuclear medicine , receiver operating characteristic , fast spin echo , radiology
Purpose: To evaluate whether diffusion‐weighted imaging (DWI) improves the detection of hepatocellular carcinoma (HCC) on super paramagnetic iron oxide (SPIO)‐enhanced MRI. Materials and Methods: This retrospective study group consisted of 30 patients with 50 HCC nodules who underwent MRI at 1.5 Tesla. Two combined MR sequence sets were compared for detecting HCC: SPIO‐enhanced MRI (axial T2‐weighted fast spin‐echo (FSE) and T1‐/T2*‐weighted fast field echo (FFE) scanned before and after administration of ferucarbotran) and SPIO‐enhanced MRI + DWI (SPIO‐enhanced MRI with axial DWI scanned before and after administration of ferucarbotran). Three blinded readers independently reviewed for the presence of HCC on a segment‐by‐segment basis using a four‐point confidence scale. The performance of the two combined MR sequence sets was evaluated using receiver operating characteristic (ROC) analysis. Results: The average area under the ROC curve (Az) of the three readers for the SPIO‐enhanced MRI + DWI set (0.870 ± 0.046) was significantly higher that that for the SPIO‐enhanced MRI set (0.820 ± 0.055) ( P = .025). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detection of HCC were 66.0%, 98.0%, 90.0%, and 91.4%, respectively, for the SPIO‐enhanced MRI set, and 70.0%, 98.6%, 92.9%, and 92.4%, respectively, for the SPIO‐enhanced MRI + DWI set. Conclusion: The SPIO‐enhanced MRI + DWI set outperformed the SPIO‐enhanced MRI set for depicting HCC. J. Magn. Reson. Imaging 2010; 31: 373–382. © 2010 Wiley‐Liss, Inc.