title: Hepatocellular carcinoma in cirrhotic livers: detection with unenhanced and iron oxide-enhanced MR imaging.
abstract: OBJECTIVE
  To evaluate diagnostic accuracy with unenhanced and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging for detection of hepatocellular carcinoma (HCC) in cirrhotic livers.
  
  
  METHODS
  Fifteen patients with 26 histologically proved HCCs associated with liver cirrhosis underwent imaging with T1-, T2-, and proton-density-weighted spin-echo (SE) and fast low-angle shot (FLASH) sequences. Lesion-to-liver contrast-to-noise ratios were measured in all sequences. Diagnostic performance of the imaging techniques was assessed by using receiver operating characteristic analysis.
  
  
  RESULTS
  Enhanced SE and FLASH sequences were significantly more accurate (P < .005) for the detection of small HCCs. Among the unenhanced pulse sequences, the accuracy of tumor localization was highest with the T2-weighted SE sequences; however, 25% of the lesions were located incorrectly. Compared with unenhanced images, lesions were correctly located more often when SPIO-enhanced SE and FLASH sequences were used.
  
  
  CONCLUSIONS
  SPIO-enhanced MR imaging with proton-density-weighted or FLASH sequences was more accurate in the detection of small HCCs in cirrhotic livers.
authors.affiliation: Department of Radiology, Kumamoto University School of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Yamashita
authors.forename: S
authors.initials: S
authors.lastname: Yoshimatsu
authors.forename: Y
authors.initials: Y
authors.lastname: Baba
authors.forename: Y
authors.initials: Y
authors.lastname: Hatanaka
authors.forename: R
authors.initials: R
authors.lastname: Murakami
authors.forename: T
authors.initials: T
authors.lastname: Nishiharu
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
authors.forename: Y
authors.initials: Y
authors.lastname: Higashida
authors.forename: N
authors.initials: N
authors.lastname: Moribe
mesh_terms: D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000175:diagnosis*; D003287:Contrast Media; D003911:Dextrans; D005189:False Positive Reactions; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007501:Iron; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D012372:ROC Curve
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide