Hepatic lesion detection at MR imaging: a comparative study with four sequences.
OBJECTIVE
To compare results with the following magnetic resonance (MR) imaging sequences in the detection of focal hepatic lesions: fast spin-echo (SE) before and after administration of superparamagnetic iron oxide (SPIO) particles, fat-suppressed T2-weighted SE, and dynamic gadolinium-enhanced fast low-angle shot (FLASH).


METHODS
In 26 patients with known malignancy and documented focal liver lesions, 1.0-T MR imaging was performed prior to hepatic resection. All images were reviewed independently by four blinded observers. Sensitivity was calculated for each sequence and for each observer by means of alternative-free-response receiver operating characteristic (ROC) methods.


RESULTS
The mean area under the alternative-free-response ROC curve with SPIO-enhanced fast SE (0.85) was significantly greater (P < .02) than that with all other sequences. Detection was significantly improved with SPIO-enhanced fast SE compared with dynamic gadolinium-enhanced FLASH (which was the best of the other three sequences) for all lesions (P < .002) and for malignant lesions (P < .0002).


CONCLUSIONS
Findings with the SPIO-enhanced fast SE sequence improved detection of focal liver lesions and had the highest diagnostic accuracy.
Blakeborough
A
A
Department of Radiology, St James's University Hospital, Leeds, England.
Ward
J
J
Wilson
D
D
Griffiths
M
M
Kajiya
Y
Y
Guthrie
J A
JA
Robinson
P J
PJ
D000273:Adipose Tissue; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D003287:Contrast Media; D004338:Drug Combinations; D005260:Female; D052203:Ferrosoferric Oxide; D005682:Gadolinium; D019786:Gadolinium DTPA; D006498:Hepatectomy; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted; D007501:Iron; D008107:Liver Diseases / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D015588:Observer Variation; D009942:Organometallic Compounds; D010087:Oxides; D004369:Pentetic Acid / Q000031:analogs & derivatives; D011300:Preoperative Care; D012372:ROC Curve; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D010087:Oxides; D008536:Meglumine; D004369:Pentetic Acid; D005682:Gadolinium; D007501:Iron; D019786:Gadolinium DTPA; D052203:Ferrosoferric Oxide