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Distinguishing hemangiomas from malignant solid hepatic lesions: A comparison of heavily T2‐weighted images obtained before and after administration of gadoxetic acid
Author(s) -
Ahn Sung Jun,
Kim MyeongJin,
Hong HyeSuk,
Ah Kim Kyung,
Song HoTaek
Publication year - 2011
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.22658
Subject(s) - gadoxetic acid , medicine , magnetic resonance imaging , radiology , nuclear medicine , lesion , receiver operating characteristic , gadolinium dtpa , pathology
Purpose: To compare the use of heavily T2‐weighted images obtained before and after administration of gadoxetic acid in differentiating hemangiomas from malignant solid hepatic lesions. Materials and Methods: Heavily T2‐weighted images (TE = 150 msec) were obtained for 70 patients (42 men and 28 women) with 74 focal hepatic lesions (25 hepatocellular carcinomas [HCC], 22 metastases, and 27 hemangiomas) ≤3 cm in diameter before and after gadoxetic acid‐enhanced dynamic magnetic resonance imaging (MRI). Quantitative analysis was performed using receiver operating characteristic (ROC) curves with lesion‐to‐liver signal intensity difference‐to‐noise ratio (SDNR) on precontrast and postcontrast images. Qualitative analysis was also performed by two blinded reviewers. Results: The SDNR of the solid lesions was significantly higher on the postcontrast (1.66 ± 1.18) than on the precontrast (1.38 ± 1.07) images ( P = 0.0012), while the SDNR of hemangiomas was comparable for pre‐ and postcontrast images ( P = 0.8164). The best SDNR cutoff values for distinguishing solid lesions from hemangiomas were ≤1.85 (Az = 0.948) for precontrast and ≤2.58 (Az = 0.901) for postcontrast images ( P = 0.057). Reader performances for distinguishing hemangiomas from solid lesions were comparable between the precontrast (Az = 0.975 and 0.970 for readers 1 and 2) and postcontrast (Az = 0.977 and 0.972) images ( P = 0.899 and 0.946). Conclusion: Heavily T2‐weighted images obtained after administration of gadoxetic acid have a diagnostic capability comparable to precontrast images for differentiating between small hemangiomas and malignant solid lesions of the liver. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.