Definition of liver tumors in the presence of diffuse liver disease: comparison of findings at MR imaging with positive and negative contrast agents.
OBJECTIVE
The potential to define liver tumors at magnetic resonance (MR) imaging was compared with a positive and a negative contrast agent (gadoxetic acid disodium, or gadolinium EOB-DTPA [a hepatocyte-directed agent], and ferumoxides, or superpara-magnetic iron oxide particles [a Kupffer cell-directed agent], respectively) in normal rats and in rats with induced acute hepatitis, fatty liver, or cirrhosis.


METHODS
Rats with implanted liver adenocarcinomas were divided into four groups: no diffuse liver disease ("normal" [n = 6]) and diffuse liver diseases (induced acute hepatitis [n = 6], fatty liver [n = 6], or cirrhosis [n = 6]). Rats first received gadoxetic acid disodium (50 mumol/kg) and then, 45 minutes later, ferumoxides (10 mumol/kg). Liver signal intensity enhancement and tumor-to-liver contrast-to-noise ratio (C/N) were measured in each group.


RESULTS
Mean liver signal intensity enhancement values with gadoxetic acid disodium and ferumoxides were excellent in the normal liver model (176% and -62%, respectively; P < .01) but were significantly reduced in the acute hepatitis model (82% and -36%, respectively). In the fatty livers compared with the normal livers, enhancement with gadoxetic acid disodium was reduced (57%) but with ferumoxides was excellent (-55%). In the cirrhotic livers compared with the normal livers, enhancement with gadoxetic acid disodium (174%) was virtually the same but was impaired with ferumoxides (-43%).


CONCLUSIONS
Hepatic enhancement and tumor-to-liver C/N with either positive or negative liver-enhancing agents can be impaired by the presence of underlying liver disease. Prior knowledge of the type of diffuse liver disease may influence the choice of contrast agent for tumor detection.
Kuwatsuru
R
R
Department of Radiology, University of California, San Francisco 94143-0628, USA.
Brasch
R C
RC
Mühler
A
A
Mathur
A
A
Vexler
V S
VS
Rosenau
W
W
Mintorovitch
J
J
Berthezene
Y
Y
Cohen
F
F
Shames
D M
DM
D000208:Acute Disease; D000818:Animals; D003287:Contrast Media; D003911:Dextrans; D005234:Fatty Liver / Q000150:complications / Q000473:pathology; D005260:Female; D052203:Ferrosoferric Oxide; D019786:Gadolinium DTPA; D006520:Hepatitis, Animal / Q000139:chemically induced / Q000150:complications / Q000473:pathology; D007501:Iron; D008099:Liver / Q000000981:diagnostic imaging; D008106:Liver Cirrhosis, Experimental / Q000150:complications / Q000473:pathology; D008107:Liver Diseases / Q000150:complications* / Q000473:pathology; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D009368:Neoplasm Transplantation; D009942:Organometallic Compounds; D010087:Oxides; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D011859:Radiography; D051381:Rats; D011916:Rats, Inbred F344
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D009942:Organometallic Compounds; D010087:Oxides; C073590:gadolinium ethoxybenzyl DTPA; D004369:Pentetic Acid; D007501:Iron; C065507:ferumoxides; D019786:Gadolinium DTPA; D052203:Ferrosoferric Oxide