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Malignant hepatic tumor detection with ferumoxides-enhanced MR imaging with a 1.5-T system: comparison of four

M Kanematsu1, K Itoh, M Matsuo

  • 1Department of Radiology, Gifu University School of Medicine, Gifu 500-8705, Japan. masa-gif@umin.ac.jp

Insights

T2-weighted fast spin-echo (SE) magnetic resonance (MR) imaging is superior for detecting malignant liver tumors and nonsolid lesions. This sequence may replace conventional SE imaging for ferumoxides-enhanced liver scans due to its speed and efficacy.

Area of Science:

  • Radiology
  • Medical Imaging
  • Hepatology

Background:

  • Ferumoxides are iron oxide nanoparticles used as contrast agents in magnetic resonance (MR) imaging.
  • Accurate detection of hepatic tumors is crucial for patient management and treatment planning.
  • Various MR imaging sequences have different sensitivities and specificities for lesion detection.

Purpose of the Study:

  • To compare observer performance in detecting malignant hepatic tumors using ferumoxides-enhanced MR images.
  • To evaluate four different MR imaging sequences: proton density-weighted spin-echo (SE), T2-weighted fast SE, T2*-weighted gradient-recalled-echo (GRE), and proton density-weighted echo-planar (EP).

Main Methods:

  • Retrospective analysis of ferumoxides-enhanced MR images from 50 patients with 92 solid malignant and 64 nonsolid benign lesions.
  • Three independent readers evaluated 397 liver segments.
  • Receiver operating characteristic (ROC) analysis was used to assess observer performance and lesion-to-liver contrast-to-noise ratio (CNR).

Main Results:

  • Proton density-weighted SE and T2-weighted fast SE images demonstrated superior performance for detecting malignant hepatic tumors compared to T2*-weighted GRE and proton density-weighted EP images.
  • T2-weighted fast SE images were optimal for detecting nonsolid lesions.
  • Lesion-to-liver CNR was higher with SE and EP for solid lesions, and with fast SE and SE for nonsolid lesions.

Conclusions:

  • T2-weighted fast SE sequences offer a promising alternative to conventional SE imaging for ferumoxides-enhanced liver MR imaging.
  • This sequence provides comparable performance for solid tumor detection and superior performance for nonsolid lesion detection.
  • The faster acquisition time of T2-weighted fast SE sequences enhances clinical utility.

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