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Hepatic lesions: detection with ferumoxide-enhanced T1-weighted MR imaging
M Oudkerk1, A G van den Heuvel, P A Wielopolski
1Department of Radiology, Dr Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
Purpose:
To compare the use of ferumoxide-enhanced T1-weighted gradient-echo (GRE) MR imaging with that of spiral computed tomography during arterial portography (CTAP) and T2-weighted Turbo spin-echo (SE) MR imaging in detection of lesions and of segmental involvement in patients with liver metastases.
Materials And Methods:
Twenty-two candidates for metastasectomy of the liver underwent spiral CTAP, ferumoxide-enhanced GRE MR imaging, and T2-weighted Turbo SE MR imaging. A total of 176 liver segments were evaluated (57 with and 119 without metastases). The reference standard was laparoscopic sonographic findings. Diagnostic performance of the imaging modalities was assessed for lesion detection and determination of segmental involvement.
Results:
The sensitivity for lesion detection with spiral CTAP, ferumoxide-enhanced MR imaging, and T2-weighted MR imaging was 0.96, 0.83, and 0.71, respectively; for segmental analysis, the sensitivity was 0.96, 0.84, and 0.75, respectively, and the specificity was 0.80, 0.99, and 0.92, respectively. All comparisons between sensitivities and specificities were statistically significant (P < .05).
Conclusion:
Ferumoxide-enhanced T1-weighted GRE MR imaging is superior to T2-weighted SE MR imaging for preoperative detection of lesions and segmental involvement in patients with liver metastases.
Insights
Ferumoxide-enhanced MRI is better than T2-weighted MRI for detecting liver metastases and their spread. Spiral CTAP is also effective for identifying liver lesions.
Area of Science:
- Hepatobiliary imaging
- Medical imaging techniques
- Oncology
Background:
- Accurate detection of liver metastases is crucial for surgical planning.
- Differentiating between various imaging modalities for liver lesion detection is an ongoing area of research.
Purpose of the Study:
- To compare ferumoxide-enhanced T1-weighted gradient-echo (GRE) MR imaging with spiral computed tomography during arterial portography (CTAP) and T2-weighted Turbo spin-echo (SE) MR imaging.
- To evaluate the diagnostic performance of these modalities in detecting liver lesions and segmental involvement in patients with liver metastases.
Main Methods:
- Twenty-two liver metastasectomy candidates underwent spiral CTAP, ferumoxide-enhanced GRE MR imaging, and T2-weighted Turbo SE MR imaging.
- A total of 176 liver segments were assessed, with laparoscopic sonography serving as the reference standard.
- Diagnostic performance was evaluated for lesion detection and segmental involvement determination.
Main Results:
- Ferumoxide-enhanced MR imaging showed higher sensitivity (0.83) for lesion detection compared to T2-weighted MR imaging (0.71).
- Spiral CTAP demonstrated the highest sensitivity for both lesion detection (0.96) and segmental analysis (0.96).
- Ferumoxide-enhanced MR imaging achieved superior specificity (0.99) in segmental analysis compared to T2-weighted MR imaging (0.92).
Conclusions:
- Ferumoxide-enhanced T1-weighted GRE MR imaging is superior to T2-weighted SE MR imaging for preoperative detection of liver metastases.
- Both ferumoxide-enhanced MRI and CTAP are valuable tools for assessing liver metastases, with CTAP showing higher sensitivity for lesion detection.