Superparamagnetic iron oxide--enhanced versus gadolinium-enhanced MR imaging for differential diagnosis of focal liver lesions.
OBJECTIVE
To assess AMI-25- versus gadolinium-enhanced magnetic resonance (MR) imaging in the differential diagnosis of liver tumors.


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.


CONCLUSIONS
AMI-25 decreased the SI of benign tumors and helped differentiate benign from malignant tumors.
Vogl
T J
TJ
Department of Radiology, Humboldt-University Berlin, Germany.
Hammerstingl
R
R
Schwarz
W
W
Mack
M G
MG
Müller
P K
PK
Pegios
W
W
Keck
H
H
Eibl-Eibesfeldt
A
A
Hoelzl
J
J
Woessmer
B
B
Bergman
C
C
Felix
R
R
D000236:Adenoma / Q000175:diagnosis; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis; D003287:Contrast Media; D003911:Dextrans; D003937:Diagnosis, Differential; D005260:Female; D052203:Ferrosoferric Oxide; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D006965:Hyperplasia; D007501:Iron; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D010087:Oxides; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D011446:Prospective Studies
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D009942:Organometallic Compounds; D010087:Oxides; D004369:Pentetic Acid; D005682:Gadolinium; D007501:Iron; C065507:ferumoxides; D019786:Gadolinium DTPA; D052203:Ferrosoferric Oxide