Magnetic resonance imaging of focal liver lesions. Comparison of the superparamagnetic iron oxide resovist versus gadolinium-DTPA in the same patient.
OBJECTIVE
The authors assess the efficacy of static and dynamic magnetic resonance (MR) imaging using the superparamagnetic iron oxide SHU-555A (Resovist) versus standard dose of gadolinium (Gd)-DTPA in patients with focal liver lesions.


METHODS
Magnetic resonance imaging was performed in 30 patients suffering from histopathologically verified malignant (n = 22) and benign (n = 8) liver lesions. T2-weighted conventional and fat-suppressed as well as T1-weighted sequences were used before, during, and after fast intravenous administration of Resovist (1 mL/minute) at three doses of 4, 8, and 16 mumol/kg body weight. One week before the Resovist-enhanced MR imaging study 20 patients underwent Gd-DTPA-enhanced MR imaging.


RESULTS
Detection rate was improved for metastatic lesions revealing 36 lesions unenhanced versus 53 focal lesions using Resovist-enhanced MR imaging. Gadolinium-DTPA-enhanced scans showed no additional lesion versus unenhanced and Resovist-enhanced MR imaging. Static and dynamic imaging demonstrated no measurable percentage signal intensity loss (PSIL) using Resovist-enhanced MR imaging versus a percentage enhancement of 79.7% in Gd-DTPA enhanced scans. In the dynamic T2-weighted sequences, hepatocellular carcinoma nodules (n = 4) showed a rapid decrease in signal intensity starting at 44 seconds. Postinfusion of Resovist followed by a low, constant increase in signal intensity. Gadolinium-DTPA enhanced scans showed a percentage enhancement of 73.4 focal nodular hyperplasia (FNH) and hemangioma revealed a strong and early dose-dependent PSIL 44 to 60 seconds postinfusion with a prolonged signal loss for the FNH in the late study. Statistical evaluation revealed a statistically significant superiority of Resovist-enhanced MR imaging concerning the detection and delineation of focal liver lesions compared with unenhanced and Gd-DTPA enhanced scans (P < 0.05).


CONCLUSIONS
The fast infusion of the new superparamagnetic contrast agent Resovist shows advantages for dynamic and static MR imaging of focal liver lesions.
Vogl
T J
TJ
Department of Radiology, Humboldt University of Berlin, Rudolf Virchow Hospital, Germany.
Hammerstingl
R
R
Schwarz
W
W
Kümmel
S
S
Müller
P K
PK
Balzer
T
T
Lauten
M J
MJ
Balzer
J O
JO
Mack
M G
MG
Schimpfky
C
C
Schrem
H
H
Bechstein
W O
WO
Neuhaus
P
P
Felix
R
R
D006528:Carcinoma, Hepatocellular / Q000175:diagnosis; D003287:Contrast Media; D003911:Dextrans; D052203:Ferrosoferric Oxide; D005500:Follow-Up Studies; D005682:Gadolinium; D019786:Gadolinium DTPA; D006391:Hemangioma / Q000175:diagnosis; D006801:Humans; D007501:Iron; D008107:Liver Diseases / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D009942:Organometallic Compounds; D010087:Oxides; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D011446:Prospective Studies; D013535:Suspensions
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D009942:Organometallic Compounds; D010087:Oxides; D013535:Suspensions; D004369:Pentetic Acid; D005682:Gadolinium; D007501:Iron; C065507:ferumoxides; D019786:Gadolinium DTPA; D052203:Ferrosoferric Oxide