Effect of superparamagnetic iron oxide-enhanced MRI of the liver with hepatocellular carcinoma and hyperplastic nodule.
OBJECTIVE
To evaluate the possibility of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) of the liver in predicting the histologic grade of hepatocellular carcinoma (HCC) and differentiating HCC from benign hyperplastic nodule (HPN).


METHODS
Thirty patients with 31 histologically proved HCC and HPN underwent MRI (1.5 Tesla). HCCs were graded into well-differentiated HCC (HCCw; n = 10) and moderately to poorly differentiated HCC (HCCmp; n = 15). HPN was categorized into dysplastic nodule (DN; n = 1) and focal nodular hyperplasia (FNH; n = 6). T2-weighted fast spin echo images were obtained before and after administration of SPIO. Signal-to-noise ratios (SNR) of the lesion and surrounding liver parenchyma and contrast-to-noise ratios (CNR) were calculated pre- and postcontrast study. Relative enhancement ratios (RER), also known as signal intensity reduction ratios of the lesions, were also calculated.


RESULTS
HCCw, HCCmp, DN, and FNH decreased in SNR after injection of SPIO. RER of HCCw was 19.5 +/- 13.3%, that of HCCmp was 6.8 +/- 5.8%, DN was 44.0%, and FNH was 42.9 +/- 4.8%. Significant statistical differences were seen between HCCw and HCCmp and HCC and HPN in RER. HCCw, HCCmp, and DN increased in CNR, and FNH decreased in CNR, but no lesion showed a statistically significant difference in CNR.


CONCLUSIONS
SPIO-enhanced MR images may help to predict the histologic grade of HCC and distinguish HCC from HPN.
Takeshita
Koji
K
Department of Radiology, Teikyo University School of Medicine, Itabashi-Ku, Tokyo, Japan. takesita@med.teikyo-u.ac.jp
Nagashima
Ikuo
I
Frui
Shigeru
S
Takada
Koichi
K
Yamauchi
Teiyu
T
Harasawa
Arimi
A
Oba
Hiroshi
H
Kohtake
Hiroshi
H
Tanaka
Hiroko
H
Suzuki
Shigeru
S
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005290:Ferric Compounds; D052203:Ferrosoferric Oxide; D020518:Focal Nodular Hyperplasia / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement; D007275:Injections, Intravenous; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
D003287:Contrast Media; D005290:Ferric Compounds; C427127:superparamagnetic blood pool agent; D052203:Ferrosoferric Oxide