title: Superparamagnetic iron oxide--enhanced versus gadolinium-enhanced MR imaging for differential diagnosis of focal liver lesions.
abstract: 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.
authors.affiliation: Department of Radiology, Humboldt-University Berlin, Germany.
authors.forename: T J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: R
authors.initials: R
authors.lastname: Hammerstingl
authors.forename: W
authors.initials: W
authors.lastname: Schwarz
authors.forename: M G
authors.initials: MG
authors.lastname: Mack
authors.forename: P K
authors.initials: PK
authors.lastname: Müller
authors.forename: W
authors.initials: W
authors.lastname: Pegios
authors.forename: H
authors.initials: H
authors.lastname: Keck
authors.forename: A
authors.initials: A
authors.lastname: Eibl-Eibesfeldt
authors.forename: J
authors.initials: J
authors.lastname: Hoelzl
authors.forename: B
authors.initials: B
authors.lastname: Woessmer
authors.forename: C
authors.initials: C
authors.lastname: Bergman
authors.forename: R
authors.initials: R
authors.lastname: Felix
mesh_terms: 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
chemical_list: 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