title: Off-site evaluation of liver lesion detection by Gd-BOPTA-enhanced MR imaging.
abstract: The aim of this study was to determine the efficacy of Gd-BOPTA-enhanced MRI in liver lesion detection in comparison with unenhanced MRI and dynamic CT. The image sets of 148 of 151 patients enrolled in a multicenter German phase-III trial were evaluated by two independent radiologists unaffiliated with the investigating centers. Patients underwent a routine MRI protocol comprising T2- and T1-weighted spin-echo and T1-weighted gradient-echo (GE) sequences pre and 1 h post 0.1 mmol/kg Gd-BOPTA (Bracco-Byk Gulden, Konstanz, Germany). Additionally, a serial T1-weighted GE scan was performed after administration of the first half of the dose. All patients underwent dynamic contrast-enhanced CT. The evaluation was performed with regard to the number and size of lesions detected per patient by each modality or sequence. Furthermore, all pre CM and pre + post CM image sets were analyzed for number of lesions per patient. Both readers detected significantly more lesions in the contrast-enhanced image set compared with the unenhanced image set (32 and 39 %, respectively; p < 0.0001). While contrast-enhanced CT detected a similar number of lesions to unenhanced MRI, it was clearly inferior to contrast-enhanced MRI (reader 1: p = 0.0117; reader 2: p = 0.0225). Of the T1-weighted scans performed, the dynamic and late T1-weighted GE exams contributed most to the increased lesion detection rate (reader 1: p = 0.0007; reader 2: p = 0.0037). The size of the smallest lesion detected by means of MRI was significantly larger in the pre-CM image sets than in the pre + post CM image sets (reader 1: p = 0.001; reader 2: p < 0.0001). Gd-BOPTA-enhanced MRI detected significantly smaller lesions than contrast-enhanced CT (reader 1: p = 0.0117; reader 2: p = 0.0925). Gd-BOPTA-enhanced MR imaging improves liver lesion detection significantly over unenhanced MRI and dynamic CT.
authors.affiliation: Institute of Diagnostic Radiology, Medical University of Lübeck, Germany. gehl@medinf.mu-luebeck.de
authors.forename: H B
authors.initials: HB
authors.lastname: Gehl
authors.forename: M
authors.initials: M
authors.lastname: Bourne
authors.forename: L
authors.initials: L
authors.lastname: Grazioli
authors.forename: A
authors.initials: A
authors.lastname: Möller
authors.forename: K P
authors.initials: KP
authors.lastname: Lodemann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage*; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage; D006801:Humans; D007275:Injections, Intravenous; D008113:Liver Neoplasms / Q000175:diagnosis*; D008297:Male; D008536:Meglumine / Q000008:administration & dosage* / Q000031:analogs & derivatives; D008875:Middle Aged; D015588:Observer Variation; D009942:Organometallic Compounds / Q000008:administration & dosage*; D011446:Prospective Studies; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D005682:Gadolinium