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Superparamagnetic iron oxide--enhanced versus gadolinium-enhanced MR imaging for differential diagnosis of focal
T J Vogl1, R Hammerstingl, W Schwarz
1Department of Radiology, Humboldt-University Berlin, Germany.
Purpose:
To assess AMI-25- versus gadolinium-enhanced magnetic resonance (MR) imaging in the differential diagnosis of liver tumors.
Materials And Methods:
Twenty-nine patients with liver tumors underwent unenhanced, AMI-25-enhanced (15 micromol/kg), and gadolinium-enhanced(0.1 mmol/kg) imaging within 2 weeks.
Results:
A significant (P< .05) difference in percentage signal intensity loss (PSIL) was seen in benign tumors on AMI-25-enhanced proton-density-weighted images (nine focal nodular hyperplasia [FNH], 41%; one adenoma, 32.4%) versus malignant tumors. Gadolinium-enhanced T1-weighted gradient-echo images showed strong enhancement in benign lesions (seven FNH, 147.5%; one adenoma, 91.3%) and moderate enhancement in malignant tumors (eight hepatocellular carcinomas, 116.2%, 11 metastases, 39.7%). Receiver operating characteristic analysis revealed a threshold PSIL of 10% on AMI-25-enhanced images as the most essential criteria to distinguish benign from malignant lesions (sensitivity, 88%; specificity. 89%). Interobserver analysis for two observers revealed specificity of 93% for AMI-25-enhanced imaging versus 81.5% for gadolinium-enhanced MR imaging.
Conclusion:
AMI-25 decreased the SI of benign tumors and helped differentiate benign from malignant tumors.