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Detection of malignant hepatic tumors: comparison of gadolinium-and ferumoxide-enhanced MR imaging
M Matsuo1, M Kanematsu, K Itoh
1Department of Radiology, Gifu University School of Medicine, 40 Tsukasamachi, Gifu City, Gifu 500-8705, Japan.
Objective:
The purpose of our study was to compare how well gadolinium-enhanced and ferumoxide-enhanced MR imaging reveal malignant hepatic tumors.
Subjects And Methods:
Both gadolinium-enhanced and ferumoxide-enhanced MR imaging were separately performed in 53 patients with a total of 87 malignant hepatic tumors (57 hepatocellular carcinomas, 28 metastases, two cholangiocarcinomas). Thirty-one of the 53 patients had hepatic cirrhosis. Images were reviewed by three independent off-site observers. Observer performance was evaluated by means of sensitivity, specificity, and receiver operating characteristic curve analyses.
Results:
Gadolinium-enhanced MR imaging outperformed ferumoxide-enhanced MR imaging in sensitivity (81% versus 62%, p < 0.01) for malignant-tumor detection. Specificity was comparable (94%) between the two types of MR imaging. Area under receiver operating characteristic curve (A(z)) value was significantly higher with gadolinium-enhanced MR imaging than with ferumoxide-enhanced MR imaging in patients overall (A(z) = 0.896 versus 0.805, p < 0.001), in patients with cirrhosis (A(z) = 0.907 versus 0.807, p < 0.001), and in patients without cirrhosis (A(z) = 0.899 versus 0.834, p < 0.01). The superiority was enhanced in the subset of patients with cirrhosis.
Conclusion:
Gadolinium-enhanced MR imaging outperforms ferumoxide-enhanced MR imaging in revealing malignant hepatic tumors. Gadolinium-enhanced MR imaging is recommended, particularly for patients with cirrhosis.
Insights
Gadolinium-enhanced MRI is superior to ferumoxide-enhanced MRI for detecting malignant liver tumors, especially in patients with cirrhosis. This finding aids in selecting optimal imaging techniques for liver cancer diagnosis.
Area of Science:
- Medical Imaging
- Hepatobiliary Malignancies
- Diagnostic Radiology
Background:
- Accurate detection of malignant hepatic tumors is crucial for patient management.
- Magnetic Resonance Imaging (MRI) is a key modality for liver lesion characterization.
- Different contrast agents may influence imaging performance.
Purpose of the Study:
- To compare the efficacy of gadolinium-enhanced MRI versus ferumoxide-enhanced MRI in revealing malignant hepatic tumors.
- To evaluate observer performance in detecting liver malignancies using both contrast agents.
Main Methods:
- Prospective study involving 53 patients with 87 malignant hepatic tumors.
- Separate administration of gadolinium-enhanced and ferumoxide-enhanced MRI.
- Image review by three independent observers.
- Performance evaluation using sensitivity, specificity, and ROC curve analysis.
Main Results:
- Gadolinium-enhanced MRI demonstrated significantly higher sensitivity (81% vs. 62%, p < 0.01) for malignant tumor detection.
- Specificity was comparable between the two agents (94%).
- Area under the ROC curve (A(z)) was significantly higher for gadolinium-enhanced MRI (0.896 vs. 0.805, p < 0.001), particularly in patients with cirrhosis.
Conclusions:
- Gadolinium-enhanced MRI is superior to ferumoxide-enhanced MRI for detecting malignant hepatic tumors.
- Gadolinium-enhanced MRI is recommended, especially for patients with hepatic cirrhosis, due to its enhanced diagnostic performance.
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