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Focal liver lesions: MR imaging with Mn-DPDP--initial clinical results in 40 patients
1Department of Radiology, Steglitz Clinic, Freie Universität Berlin, Germany.
Abstract:
Manganese (II) N,N'-dipyridoxylethylenediamine-N,N'-diacetate-5,5'-bis(phosphate) (DPDP) was evaluated as a contrast agent for magnetic resonance (MR) imaging (1.5 T) of focal liver lesions in 40 patients. Doses of 5 and 10 mumol/kg were administered intravenously. Mn-DPDP-enhanced T1-weighted images were compared quantitatively and subjectively with standard T1- and T2-weighted nonenhanced images. Use of Mn-DPDP resulted in a statistically significant increase in signal intensity of liver parenchyma in T1-weighted images at both doses. No enhancement was seen in metastases, cholangiocarcinomas, or lymphomas, while all hepatocellular carcinomas were enhanced. Enhancement was seen in focal nodular hyperplasia and in regenerative nodules. The lesion-to-liver contrast in Mn-DPDP-enhanced gradient-recalled-echo images was superior to that of all precontrast images (P less than .01). The number of nonenhancing malignant liver lesions detected in spin-echo (SE) images was increased (272 in T2-weighted SE images vs 390 in T1-weighted Mn-DPDP-enhanced SE images). Image interpretation (eg, visualization and demarcation of the lesions) was markedly better in Mn-DPDP-enhanced images than in all precontrast images (P less than .001).
Insights
Manganese (II) N,N'-dipyridoxylethylenediamine-N,N'-diacetate-5,5'-bis(phosphate) (Mn-DPDP) significantly improved liver lesion contrast in MRI scans. This contrast agent enhanced visualization and detection of hepatocellular carcinomas and focal nodular hyperplasia.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Focal liver lesions require accurate diagnostic tools.
- Magnetic Resonance Imaging (MRI) is a key modality for liver lesion characterization.
- Developing effective contrast agents is crucial for improving MRI sensitivity and specificity.
Purpose of the Study:
- To evaluate Manganese (II) N,N '-dipyridoxylethylenediamine-N,N '-diacetate-5,5 '-bis(phosphate) (Mn-DPDP) as an MRI contrast agent for focal liver lesions.
- To assess the impact of Mn-DPDP on lesion-to-liver contrast and image interpretation.
- To compare the efficacy of Mn-DPDP-enhanced MRI with standard nonenhanced sequences.
Main Methods:
- A study involving 40 patients with focal liver lesions.
- Intravenous administration of Mn-DPDP at doses of 5 and 10 mumol/kg.
- Quantitative and subjective comparison of Mn-DPDP-enhanced T1-weighted images with precontrast T1- and T2-weighted images.
Main Results:
- Mn-DPDP significantly increased liver parenchyma signal intensity on T1-weighted images.
- Hepatocellular carcinomas, focal nodular hyperplasia, and regenerative nodules showed enhancement.
- Metastases, cholangiocarcinomas, and lymphomas did not enhance.
- Lesion-to-liver contrast was superior in Mn-DPDP-enhanced images compared to precontrast images.
- Detection of nonenhancing malignant lesions and overall image interpretation were markedly improved.
Conclusions:
- Mn-DPDP is an effective MRI contrast agent for evaluating focal liver lesions.
- It enhances visualization of certain liver lesions, particularly hepatocellular carcinomas.
- Mn-DPDP improves lesion detection and characterization, aiding in better image interpretation.