Usefulness of combining sequentially acquired gadobenate dimeglumine-enhanced magnetic resonance imaging and resovist-enhanced magnetic resonance imaging for the detection of hepatocellular carcinoma: comparison with computed tomography hepatic arteriography and computed tomography arterioportography using 16-slice multidetector computed tomography.
OBJECTIVE
To investigate the diagnostic efficacy of sequentially acquired gadobenete dimeglumine-enhanced 3-dimensional dynamic magnetic resonance imaging (MRI) and Resovist-enhanced MRI for detecting hepatocellular carcinoma (HCC) by comparing with combined computed tomography (CT) hepatic arteriography (CTHA) and CT arterioportography (CTAP) using 16-slice multidetector CT.


METHODS
Twenty-nine patients with 50 HCCs underwent sequentially acquired double-contrast MRI--gadobenate dimeglumine-enhanced dynamic MRI and Resovist-enhanced MRI--and combined CTHA and CTAP using 16-slice multidetector CT. Dynamic MRI was obtained using volumetric interpolated technique and sensitivity encoding on a 1.5-T unit. Resovist-enhanced MRI was composed of T2-weighted turbo spin-echo and T2*-weighted gradient echo sequences. Sensitivity, positive predictive value, and diagnostic accuracy for double-contrast MRI, gadolinium-enhanced MRI, and combined CTHA and CTAP were calculated by 2 observers using an alternative-free response receiver operating characteristic analysis.


RESULTS
For all observers, the Az values of double-contrast MRI (mean, 0.96) and combined CTHA and CTAP (mean, 0.93) were similar, which tended to be better than that of gadolinium-enhanced MRI (mean, 0.91). The sensitivity of double-contrast MRI (mean, 93%) and combined CTHA and CTAP (mean, 92%) was equivalent for all observers, which was better than that of gadolinium-enhanced MRI (mean, 85%; P < 0.05). The positive predictive value of double-contrast MRI was better than that of combined CTHA and CTAP (P < 0.05).


CONCLUSIONS
The sequentially acquired double-contrast MRI and combined CTHA and CTAP showed a similar diagnostic accuracy and sensitivity for detecting HCC.
Kim
Young Kon
YK
Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, South Korea. jmyr@dreamwiz.com
Kwak
Hyo Sung
HS
Han
Young Min
YM
Kim
Chong Soo
CS
D000792:Angiography / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D003131:Combined Modality Therapy; D003287:Contrast Media; D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007501:Iron; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D010087:Oxides; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D009942:Organometallic Compounds; D010087:Oxides; C064572:gadobenic acid; D008536:Meglumine; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide