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Detection of liver metastases using gadoxetic‐enhanced dynamic and 10‐ and 20‐minute delayed phase MR imaging
Author(s) -
Jeong Hyeon Tae,
Kim MyeongJin,
Park MiSuk,
Choi JinYoung,
Choi Jin Sub,
Kim Kyung Sik,
Choi Gi Hong,
Shin SangJoon
Publication year - 2012
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.22880
Subject(s) - medicine , magnetic resonance imaging , nuclear medicine , chemotherapy , lesion , radiology , subgroup analysis , significant difference , surgery , confidence interval
Purpose: To assess the incremental value of hepatobiliary phase images in gadoxetate disodium‐enhanced magnetic resonance imaging (MRI), and to compare diagnostic accuracy and lesion conspicuity on 10‐ and 20‐minute delayed images for preoperative detection of hepatic metastases with subgroup analysis according to size and history of chemotherapy. Materials and Methods: Forty‐six patients with 107 metastases who underwent surgery after gadoxetate disodium‐enhanced MRI were evaluated. Four observers independently interpreted three sets: dynamic set comprising precontrast T1‐, T2‐weighted, and dynamic images; 10‐minute set comprising dynamic set and 10‐minute delayed; 20‐minute set comprising 10‐minute set and 20‐minute delayed. Diagnostic accuracy was compared with subgroup analysis. Liver‐to‐lesion signal ratio (SR) was calculated using the region of interest method and compared. Results: Mean A z and sensitivities were significantly higher for 10‐ ( A z = 0.894, sensitivity = 95.6%) and 20‐minute (0.910, 97.2%) than dynamic set (0.813, 79.9%) ( P < 0.001), with no significant difference between 10‐ and 20‐minute sets ( P = 0.140). In patients with small (≤1 cm) metastases and a history of chemotherapy, sensitivities were significantly higher with 10‐ (88.2%) and 20‐minute (91.6%) sets than dynamic set (48.6%) ( P < 0.001). SR was significantly higher for 10‐ and 20‐minute delayed than precontrast and dynamic, with significantly higher SR on 20‐ than 10‐minute delayed. Conclusion: Regardless of size or prior chemotherapy, detection of hepatic metastases was significantly improved by adding hepatobiliary phase images without significant differences between 10‐ and 20‐minute delayed. J. Magn. Reson. Imaging 2012;35:635‐643. © 2011 Wiley Periodicals, Inc.