Detection of hepatocellular carcinoma by ferucarbotran-enhanced magnetic resonance imaging: the efficacy of accumulation phase fat-suppressed T1-weighted imaging

Aim

To evaluate the effectiveness of accumulation phase, fat-suppressed, T1-weighted imaging (FS-T1WI) when detecting hepatocellular carcinoma (HCC) by ferucarbotran-enhanced magnetic resonance imaging (MRI).

Materials and methods

Thirty patients who underwent ferucarbotran-enhanced MRI, which resulted in 35 confirmed HCCs, were included in this prospective study. Two image sets were prepared and two radiologists independently reviewed these in two reading sessions; set A was without contrast-enhanced accumulation phase FS-T1WI and set B included contrast-enhanced accumulation phase FS-T1WI. All HCCs had been confirmed by operation (n=4), by biopsy (n=28), and by follow-up study for at least 1 year (n=3).

Results

The contrast-to-noise ratio significantly increased from −1.2±7.5 to 12.7±7.3 with contrast-enhanced accumulation phase FS-T1WI, but was only slightly increased from 12.2±10.3 to 15.5±12.2 with contrast-enhanced T2WI (p<0.001). The signal-to-noise ratio (SNR) was decreased with T1WI and T2WI for liver parenchyma. With T2WI, the SNR for HCCs was decreased; however, it was slightly increased with T1WI (p<0.001). Overall, 29 HCCs were detected using set A, and 35 nodules were identified using set B, which included the contrast-enhanced accumulation phase FS-T1WI. Thus, the detection rate significantly increased using post-contrast medium accumulation phase FS-T1WI (p<0.05).

Conclusion

Due to the improved CNR with the post-contrast medium accumulation phase FS-T1WI, which helped to increase HCC detection, accumulation phase FS-T1WI is recommended as one of the routine protocols for inclusion in HCC detection.