Preoperative detection of hepatocellular carcinoma: ferumoxides-enhanced versus mangafodipir trisodium-enhanced MR imaging.
OBJECTIVE
The purpose of our study was to compare the diagnostic accuracy and lesion conspicuity of ferumoxides-enhanced MR imaging with those of mangafodipir trisodium-enhanced MR imaging for the preoperative detection of hepatocellular carcinoma.


METHODS
Twenty-one patients with 39 hepatocellular carcinomas underwent ferumoxides-enhanced and mangafodipir trisodium-enhanced MR imaging. The diagnosis was established by pathologic examination after surgical resection in all patients. Five MR sequences were obtained 30 min after ferumoxides administration, and two MR sequences were obtained before and 15 min after mangafodipir trisodium administration. Three observers independently interpreted both MR images of all sequences on a segment-by-segment basis. The diagnostic accuracy of MR imaging was assessed using receiver operating characterizing analysis. Lesion (hepatocellular carcinoma > 10 mm in diameter)-to-liver contrast-to-noise ratio was calculated on MR images.


RESULTS
Ferumoxides-enhanced MR imaging (A(z) = 0.971) was significantly more accurate (p < 0.05) than mangafodipir trisodium-enhanced MR imaging (A(z) = 0.950). The mean sensitivity of ferumoxides-enhanced MR imaging (86%) was significantly greater (p < 0.05) than that of mangafodipir trisodium-enhanced MR imaging (44%) in lesions smaller than 10 mm. The mean lesion-to-liver contrast-to-noise ratio of hepatocellular carcinoma on ferumoxides-enhanced MR imaging (13.7 +/- 8.8) was significantly greater than on mangafodipir trisodium-enhanced MR imaging (5.4 +/- 5.1) (p < 0.01).


CONCLUSIONS
Ferumoxides-enhanced MR imaging has superior diagnostic accuracy in lesions smaller than 10 mm and superior lesion conspicuity compared with mangafodipir trisodium-enhanced MR imaging for the preoperative detection of hepatocellular carcinoma.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
Seung Kwon
SK
Kim
Seung Hoon
SH
Kim
Won Jae
WJ
Lee
Hana
H
Kim
Jung Wook
JW
Seo
Dongil
D
Choi
Hyo K
HK
Lim
Soon Jin
SJ
Lee
Jae Hoon
JH
Lim
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery*; D003287:Contrast Media; D003911:Dextrans; D004492:Edetic Acid / Q000031:analogs & derivatives*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007501:Iron; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D011300:Preoperative Care; D011732:Pyridoxal Phosphate / Q000031:analogs & derivatives*; D012680:Sensitivity and Specificity
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; D007501:Iron; C065507:ferumoxides; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid; D052203:Ferrosoferric Oxide