Improved focal liver lesion detection: comparison of single-shot spin-echo echo-planar and superparamagnetic iron oxide (SPIO)-enhanced MRI.
OBJECTIVE
To prospectively compare single-shot spin-echo echo-planar imaging (SSSE-EPI) using b = 0, 10, 150, and 400 seconds/mm(2) with standard MRI techniques after intravenous super paramagnetic iron oxide (SPIO) in the detection and characterization of focal liver lesions with focus on small (<10 mm) focal liver lesions.


METHODS
A total of 25 patients suspected for colorectal liver metastases were included. Number of detected lesions was evaluated. Image quality was compared between SSSE-EPI sequence and post-SPIO (fat-suppressed T1-weighted [T1w] gradient echo [GE], T2-weighted [T2w] turbo spin echo [TSE] and T2* GE) sequences using rank order statistic (RIDIT). Lesion characterization was performed for SSSE-EPI and for all remaining sequences pre- and post-SPIO. Reference standard comprised surgery, biopsy, and/or follow-up.


RESULTS
Reference standard demonstrated 25 hemangiomas and 70 metastases. Best lesion detection respectively best image quality (P < 0.05) was achieved with SSSE-EPI (b = 10 seconds/mm(2)) post-SPIO T1w GE and T2w turbo spin echo. Lesion characterization using all sequences pre- and post-SPIO performed best for lesion characterization compared with SSSE-EPI.


CONCLUSIONS
This preliminary study shows the potential of SSSE-EPI as a stand-alone sequence for the detection of liver hemangiomas and metastases when compared with SPIO-enhanced imaging. Sequences pre- and post-SPIO are needed for qualitative lesion characterization.
Department of Radiology, Bruges, Belgium. kenneth.coenegrachts@azbrugge.be
Kenneth
K
Coenegrachts
Hans
H
Orlent
Leon
L
ter Beek
Marc
M
Haspeslagh
Shandra
S
Bipat
Jaap
J
Stoker
Hans
H
Rigauts
D015179:Colorectal Neoplasms / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage*; D003911:Dextrans; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007275:Injections, Intravenous; D007501:Iron / Q000008:administration & dosage*; D008113:Liver Neoplasms / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000008:administration & dosage*; D051598:Whole Body Imaging
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide