Routine MR imaging protocol with breath-hold fast scans: diagnostic efficacy for focal liver lesions.
OBJECTIVE
To qualitatively and quantitatively evaluate the diagnostic efficacy of the breath-hold magnetic resonance (MR) imaging sequences in widespread clinical use for detection and characterization of focal hepatic lesions.


METHODS
Fifty patients with 143 lesions [57 hepatocellular carcinomas (HCC), 10 borderline lesions, 18 metastatic tumors, 21 hemangiomas, and 37 cysts] underwent single-shot fast spin echo (SSFSE), fast spin echo (FSE), and gadolinium-enhanced dynamic fast spoiled gradient-recalled acquisition in steady state (FSPGR) breath-hold MR imaging of the liver. Alternative free receiver operating characteristic (AFROC) analysis was performed to independently and prospectively assess each sequence.


RESULTS
For solid lesions, dynamic FSPGR allowed the most sensitive lesion detection and produced the highest lesion conspicuity and lesion-liver contrast-to-noise ratio (CNR). For non-solid benign lesions, SSFSE and FSE produced better results than dynamic FSPGR. SSFSE allowed the most sensitive detection and produced the best lesion conspicuity and lesion-liver CNR.


CONCLUSIONS
SSFSE and dynamic FSPGR comprise the optimal imaging protocol for breath-hold MR assessment of focal hepatic lesions. This combination of sequences allows acquisition of critical diagnostic information about both inherent T2 and T1 lesion contrast and lesion vascularity.
Tanimoto
Akihiro
A
Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan.
Yuasa
Yuji
Y
Jinzaki
Masahiro
M
Nakatsuka
Seishi
S
Takeda
Toshiaki
T
Kurata
Tadayoshi
T
Shinmoto
Hiroshi
H
Kuribayashi
Sachio
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis; D003560:Cysts / Q000175:diagnosis; D005260:Female; D006391:Hemangioma / Q000175:diagnosis; D006801:Humans; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012372:ROC Curve