Preoperative depiction of hepatocellular carcinoma: ferumoxides-enhanced MR imaging versus triple-phase helical CT.
OBJECTIVE
To compare ferumoxides-enhanced magnetic resonance (MR) imaging with triple-phase helical computed tomography (CT) for the preoperative depiction of hepatocellular carcinoma (HCC).


METHODS
Seventy consecutive patients with a total of 79 HCC nodules underwent ferumoxides-enhanced MR imaging and triple-phase helical CT before surgery. The diagnosis of HCC was established by means of pathologic examination after surgical resection in all patients. MR images obtained with all sequences and triple-phase helical CT images were reviewed independently by three radiologists on a segment-by-segment basis. Accuracy for diagnosis of HCC was assessed by applying receiver operating characteristic (ROC) analysis to observations of 78 hepatic segments with at least one HCC nodule and 70 segments without HCC.


RESULTS
The diagnostic accuracy of findings at ferumoxides-enhanced MR imaging (with mean area-under-the-ROC-curve [A(z)] values for the three observers of 0.986, 0.979, and 0.980) was significantly higher (P <.001) than that of findings at triple-phase helical CT (with mean A(z) values for the three observers of 0.945, 0.948, and 0.964). The mean sensitivity of MR imaging (95%, 222 of 234 segments) was also significantly higher than that of triple-phase helical CT (88%, 205 of 234 segments) (P =.001, McNemar test). The mean specificity was 97% (261 of 270 segments) for MR imaging and 98% (264 of 270 segments) for CT, but this difference was not significant (P =.754, McNemar test).


CONCLUSIONS
Ferumoxides-enhanced MR imaging is superior to triple-phase helical CT for the preoperative depiction of HCC.
Kang
Bo Kiung
BK
Department of Radiology and Center for Imaging Science, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
Lim
Jae Hoon
JH
Kim
Seung Hoon
SH
Choi
Dongil
D
Lim
Hyo Keun
HK
Lee
Won Jae
WJ
Lee
Soon Jin
SJ
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007501:Iron; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed
D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide