Superparamagnetic iron oxide-enhanced liver MRI with SHU 555 A (RESOVIST): New protocol infusion to improve arterial phase evaluation--a prospective study.
OBJECTIVE
To compare the arterial enhancement of hypervascular hepatic lesions by T1-weighted 3D-GRE (gradient-recalled echo) fat-sat sequence after slow (0.5 mL/sec) and fast (2 mL/sec) RESOVIST infusion.


METHODS
We prospectively enrolled 71 patients with hypervascular hepatic lesions to undergo dynamic magnetic resonance imaging (MRI) examination with RESOVIST. A total of 92 benign and malignant lesions, 44 of which histologically confirmed, were examined. Three blinded and independent readers visually assessed the arterial enhancement using a score from 0 (none) to 3 (maximum), the latter score comparable to that achievable by MultiHance administration.


RESULTS
Out of the 92 hypervascular lesions, 41, 31, and 20 nodules were examined using the slow, fast, and both protocols, respectively. Relevant enhancement (scores 2-3) was found in 42% vs. 14.5% of cases for slow and fast protocols, respectively. Intraindividual comparison evaluation confirmed the better results obtained by slow than fast protocol (25% vs. 10%), with statistically relevant difference in distribution of scores (P=0.0004). The slow protocol showed values between 0 and 3 with an arithmetic mean of 1.1; the fast one, on the other hand, showed values between 0 and 2 with an arithmetic mean of 0.66.


CONCLUSIONS
Slow infusion improves arterial enhancement after RESOVIST administration.
Grazioli
Luigi
L
Department of Radiology, Azienda Ospedaliera Spedali Civili Brescia, University of Brescia, Brescia, Italy. lgrazioli@yahoo.com
Bondioni
Maria Pia
MP
Romanini
Laura
L
Frittoli
Barbara
B
Gambarini
Sebastiana
S
Donato
Francesco
F
Santoro
Lucia
L
Colagrande
Stefano
S
D000328:Adult; D000368:Aged; D003287:Contrast Media; D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007501:Iron; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010087:Oxides; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide