title: Detection of hypervascular hepatocellular carcinoma: comparison of SPIO-enhanced MRI with dynamic helical CT.
abstract: OBJECTIVE
  The purpose of this study was to compare the diagnostic performance of superparamagnetic iron oxide (SPIO)-enhanced MRI for the detection of hypervascular hepatocellular carcinoma (HCC) with dynamic helical CT.
  
  
  METHODS
  SPIO-enhanced MR and dynamic helical CT images obtained from 41 patients with 52 hypervascular HCCs (5-130 mm; mean, 27 mm) were retrospectively analyzed. MRI were obtained with 1.5 T scanners using T2-weighted and proton density-weighted spin-echo (or fast spin-echo) sequences for all cases and a T2*-weighted gradient echo sequence for 36 cases. Four blinded observers reviewed images independently. Diagnostic accuracy was evaluated using alternative-free response receiver operating characteristic (AFROC) method. Sensitivities and positive predictive values (PPV) were also evaluated.
  
  
  RESULTS
  The areas under the AFROC curves for each observer were greater for MR than for CT (means, 0.81 and 0.76; p < 0.05). The mean sensitivities for MR and CT were 0.75 and 0.71, respectively (p = 0.13). The mean PPVs were 0.83 and 0.79 (p = 0.21).
  
  
  CONCLUSIONS
  SPIO-enhanced MRI showed slightly better diagnostic performance than dynamic helical CT for the detection of hypervascular HCCs.
authors.affiliation: Department of Radiology, Osaka University Graduate School of Medicine, D1, 2-2, Yamadaoka, Suita-city, Osaka 565-0871, Japan. mhori@radiol.med.osaka-u.ac.jp
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hori
authors.forename: Takamichi
authors.initials: T
authors.lastname: Murakami
authors.forename: Tonsok
authors.initials: T
authors.lastname: Kim
authors.forename: Kyo
authors.initials: K
authors.lastname: Tsuda
authors.forename: Satoru
authors.initials: S
authors.lastname: Takahashi
authors.forename: Atsuya
authors.initials: A
authors.lastname: Okada
authors.forename: Manabu
authors.initials: M
authors.lastname: Takamura
authors.forename: Hironobu
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*