Hepatic metastases and cavernous hemangiomas: distinction with standard- and triple-dose gadoteridol-enhanced MR
D G Mitchell1, S Saini, J Weinreb
1Department of Radiology, Thomas Jefferson University Hospital and Jefferson Medical College, Philadelphia, PA 19107.
Purpose:
To determine if hepatic metastases can be distinguished from cavernous hemangiomas by pattern analysis of magnetic resonance (MR) images obtained prior to and following administration of gadoteridol at standard (0.1 mmol/kg) and triple (0.3 mmol/kg) doses.
Materials And Methods:
Ninety-five patients with proved hepatic metastases (n = 71) or cavernous hemangiomas (n = 24) underwent MR imaging at 16 different institutions. T2-weighted spin-echo and T1-weighted images were obtained before and after gadoteridol administration. Two independent blinded reviewers rated individual features of benignancy versus malignancy on a five-point confidence scale.
Results:
The most useful diagnostic features, with 100% specificity, were nodular enhancement for hemangiomas and rim enhancement for metastases. Confident (definitely benign or definitely malignant) diagnoses were rendered in 80 of 95 cases (84%), with an accuracy of a confident diagnosis of 96%.
Conclusion:
The pattern of enhancement on T1-weighted images is highly accurate for distinction between hemangiomas and metastases in images obtained with both doses.
