title: Detection of hepatocellular carcinoma with ferucarbotran (resovist)-enhanced breath-hold MR imaging: feasibility of 10 minute-delayed images.
abstract: OBJECTIVE
  We evaluated the optimal timing for breath-hold MR imaging with bolus-injectable superparamagnetic iron oxide (SPIO) for detecting hepatocellular carcinoma (HCC).
  
  
  METHODS
  Twenty patients with 62 HCCs (52 hypervascular, 10 non-hypervascular) underwent MR imaging that included unenhanced and SPIO-enhanced T1-weighted gradient echo (GRE) and T2-weighted fast spin echo (FSE) sequences, perfusion study, and SPIO-enhanced T2*-weighted GRE sequences. We obtained SPIO-enhanced T2*-weighted sequences 10 and 30 min after injecting SPIO and made 2 image sets, comprising 10- or 30-min delayed T2*-weighted images. Three observers performed alternative free response receiver operating characteristic (AFROC) analysis, and quantitative evaluation was performed.
  
  
  RESULTS
  Only Observers 2 and 3 recognized a significant difference in the area under the AFROC curve (Az) value in the 10-min delayed images; no significant difference was observed in the 30-min delayed images. There was no significant difference in the sensitivity of individual observers between 10- and 30-min delayed images. The contrast-to-noise (C/N) ratio of the 30-min delayed images was significantly higher than that of the 10-min delayed images. The C/N ratio of hypervascular HCCs in the 30-min delayed images was significantly higher than in the 10-min delayed images, but that of non-hypervascular HCCs showed no significant difference.
  
  
  CONCLUSIONS
  In most cases, 10-min delayed SPIO-enhanced T2*-weighted images are sufficient to detect HCCs.
authors.affiliation: Department of Radiology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Saito
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shindo
authors.forename: Taizo
authors.initials: T
authors.lastname: Ozuki
authors.forename: Aimi
authors.initials: A
authors.lastname: Ishikawa
authors.forename: Fumio
authors.initials: F
authors.lastname: Kotake
authors.forename: Yoko
authors.initials: Y
authors.lastname: Shimazaki
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Abe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D003911:Dextrans; D005240:Feasibility Studies; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007501:Iron; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide