Dynamic gadolinium-DOTA-enhanced MR imaging at 1.0 T. Value in the differentiation of hepatic tumors

A prospective study was performed to determine the value of dynamic gadolinium-tetraazacyclododecane-tetraacetic acid (Gd-DOTA)-enhanced magnetic resonance (MR) imaging at 1.0 T, using a gradient-echo (GRE) technique, in the differentiation of hepatic tumors. Fifty patients with hemangiomas (n = 14), focal nodular hyperplasia (n = 4), and malignant tumors of the liver (n = 32) underwent GRE MR imaging at 1.0 T before and repeatedly for 4 minutes after intravenous bolus administration of Gd-DOTA. The diagnoses were proved by histology or follow-up examination. On unenhanced GRE images, hemangiomas had a significantly lower tumor-to-liver contrast-to-noise (C/N) ratio (-14.74 +/- 4.49) than did the other tumors (-6.96 +/- 5.49) (p < 0.02), and benign tumors had a significantly lower C/N ratio (-12.43 +/- 5.99) than did malignant tumors (-7.29 +/- 5.71) (p < 0.05). On contrast-enhanced images, hemangiomas had a significantly lower C/N ratio (-17.60 +/- 6.90) than did the other tumors (-5.07 +/- 12.12) (p < 0.05) in the early phase. During the delayed phase, hemangiomas had a significantly higher C/N ratio (3.90 +/- 3.81) than did the other tumors (-4.85 +/- 6.51) (p < 0.01), and benign tumors had a significantly higher C/N ratio (3.21 +/- 3.65) than did malignant tumors (-5.56 +/- 6.56) (p < 0.001). Our data suggest that dynamic Gd-DOTA-enhanced MR imaging at 1.0 T provides useful information to differentiate between benign and malignant hepatic tumors, and to distinguish hemangiomas from the other tumors.