Comparison of gadoxetic acid-enhanced MRI and superparamagnetic iron oxide-enhanced MRI for the detection of hepatocellular carcinoma

Kim, Y.K.; Kim, C.S.; Han, Y.M.; Park, G.; Hwang, S.B.; Yu, H.C.

doi:10.1016/j.crad.2009.11.012

« Previous Next »Clinical Radiology
Volume 65, Issue 5 , Pages 358-365, May 2010

Comparison of gadoxetic acid-enhanced MRI and superparamagnetic iron oxide-enhanced MRI for the detection of hepatocellular carcinoma

Y.K. Kim
- Department of Diagnostic Radiology, Research Institute of Clinical Medicine, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, Republic of Korea
- Guarantor and correspondent: Y.K. Kim, Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, Republic of Korea. Tel.: +82 63 250 2314; fax: +82 63 272 0481.
C.S. Kim
- Department of Diagnostic Radiology, Research Institute of Clinical Medicine, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, Republic of Korea
Y.M. Han
- Department of Diagnostic Radiology, Research Institute of Clinical Medicine, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, Republic of Korea
G. Park
- Department of Diagnostic Radiology, Research Institute of Clinical Medicine, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, Republic of Korea
S.B. Hwang
- Department of Diagnostic Radiology, Research Institute of Clinical Medicine, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, Republic of Korea
H.C. Yu
- Department of General Surgery, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, Republic of Korea

Received 22 May 2009; received in revised form 15 September 2009; accepted 23 November 2009. published online 05 April 2010.

Aim

To compare the diagnostic accuracy and sensitivity of gadoxetic acid-enhanced MRI and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) for the detection of hepatocellular carcinoma (HCC).

Materials and methods

Eighty-nine patients (118 HCCs) who underwent three-dimensional gadoxetic acid-enhanced MRI and SPIO-enhanced MRI with a mean interval of 4.7 days (range 3–7 days), were included in this study. Two observers reviewed the gadoxetic acid set (unenhanced, early dynamic, 10 and 20 min hepatocyte-phase images) and SPIO set [unenhanced and ferucarbotran-enhanced T1-, T2-turbo spin-echo (TSE), and T2* weighted imaging (WI)] in consensus. Diagnostic accuracy and sensitivity were evaluated using the alternative-free response receiver operator characteristic (ROC) method.

Results

The area under ROC curve (Az value) and sensitivity of the gadoxetic acid set (Az 0.964; sensitivity 90.7%) were significantly higher than those of the SPIO set (Az 0.830; sensitivity 84.7%; p<0.05). There were 14 and seven lesions that were verified only on the gadoxetic acid set and only on the SPIO set, respectively. Four HCCs were clearly revealed as hypointense only on gadoxetic acid-enhanced hepatocyte phase imaging, but were occult on other sequences, including the SPIO set.