Detection of hepatic metastases: ferumoxides-enhanced MR imaging versus unenhanced MR imaging and CT during arterial portography.
OBJECTIVE
To prospectively compare the diagnostic accuracy of computed tomography (CT) during arterial portography (CTAP) with that of unenhanced and ferumoxides-enhanced magnetic resonance (MR) imaging at 0.5 T in the detection of hepatic metastases.


METHODS
Four pairs of radiologists independently assessed the metastatic involvement of 134 hepatic segments (31 with and 103 without metastasis) in 17 patients at unenhanced and ferumoxides-enhanced spin-echo and gradient-echo MR imaging (alone and in combination) and at CTAP. The diagnostic performance of the various imaging modalities was assessed by means of receiver operating characteristic analysis.


RESULTS
The accuracy of CTAP, unenhanced MR imaging (combined unenhanced sequences), and ferumoxides-enhanced MR imaging (combined contrast material-enhanced sequences) was 0.925, 0.908, and 0.951, respectively. Ferumoxides-enhanced MR imaging was significantly more accurate (P < .05) than unenhanced MR imaging and CTAP. When 14 segments containing cysts were excluded, the difference between ferumoxides-enhanced MR imaging and CTAP was no longer statistically significant (P = .1).


CONCLUSIONS
Ferumoxides-enhanced MR imaging is more accurate than unenhanced MR imaging and at least as accurate as CTAP for the detection of hepatic metastases.
Senéterre
E
E
Department of Medical Imaging, Hôpital St Eloi, Montpellier, France.
Taourel
P
P
Bouvier
Y
Y
Pradel
J
J
Van Beers
B
B
Daures
J P
JP
Pringot
J
J
Mathieu
D
D
Bruel
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003911:Dextrans; D005189:False Positive Reactions; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007430:Intraoperative Care; D007501:Iron; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D011172:Portography / Q000379:methods*; D011446:Prospective Studies; D012372:ROC Curve; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D014463:Ultrasonography
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide