Comparison of superparamagnetic iron oxide-enhanced and gadobenate dimeglumine-enhanced dynamic MRI for detection of small hepatocellular carcinomas.
OBJECTIVE
The purpose of this study was to compare superparamagnetic iron oxide (SPIO)-enhanced MRI with gadobenate dimeglumine-enhanced MRI for the detection of hepatocellular carcinoma using receiver operating characteristic (ROC) analysis.


METHODS
Twenty-nine consecutive patients with 35 hepatocellular carcinomas underwent gadobenate dimeglumine-enhanced MRI (unenhanced, arterial, portal, and equilibrium phases) using 3D fat-saturated volumetric interpolated imaging and SPIO-enhanced MRI on a 1.5-T unit. SPIO-enhanced T2-weighted turbo spin-echo and T2*-weighted gradient-echo sequences were performed 48 hr after completion of the dynamic study. Three observers independently interpreted the images in random order, separately, and without patient identifiers. Diagnostic accuracy was evaluated using the alternative free response receiver operating characteristic method. Sensitivity and positive predictive value were also evaluated.


RESULTS
The mean sensitivity and positive predictive value of SPIO-enhanced imaging were 81.0% and 85.0%, respectively, and those of gadobenate dimeglumine-enhanced MRI were 91.4% and 88.1%, respectively. A significant difference was seen in the sensitivity of the two MRI examinations (p < 0.05). The mean value of the area under the ROC curve (A(z)) for gadobenate dimeglumine-enhanced imaging (A(z) = 0.97 +/- 0.01) was significantly higher than that for SPIO-enhanced imaging (A(z) = 0.90 +/- 0.02) (p = 0.004).


CONCLUSIONS
Gadobenate dimeglumine-enhanced 3D dynamic imaging showed better diagnostic performance than SPIO-enhanced imaging for the detection of hepatocellular carcinomas.
Kim
Young Kon
YK
Department of Diagnostic Radiology, Chonbuk National University Hospital, Conju, Korea.
Kim
Chong Soo
CS
Lee
Young Hwan
YH
Kwak
Hyo Sung
HS
Lee
Jeong Min
JM
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007501:Iron; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D010087:Oxides; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D009942:Organometallic Compounds; D010087:Oxides; C097921:ferumoxtran-10; C064572:gadobenic acid; D008536:Meglumine; D007501:Iron; D052203:Ferrosoferric Oxide