title: Detection of hepatocellular carcinoma (HCC) using super paramagnetic iron oxide (SPIO)-enhanced MRI: Added value of diffusion-weighted imaging (DWI).
abstract: OBJECTIVE
  To evaluate whether diffusion-weighted imaging (DWI) improves the detection of hepatocellular carcinoma (HCC) on super paramagnetic iron oxide (SPIO)-enhanced MRI.
  
  
  METHODS
  This retrospective study group consisted of 30 patients with 50 HCC nodules who underwent MRI at 1.5 Tesla. Two combined MR sequence sets were compared for detecting HCC: SPIO-enhanced MRI (axial T2-weighted fast spin-echo (FSE) and T1-/T2*-weighted fast field echo (FFE) scanned before and after administration of ferucarbotran) and SPIO-enhanced MRI + DWI (SPIO-enhanced MRI with axial DWI scanned before and after administration of ferucarbotran). Three blinded readers independently reviewed for the presence of HCC on a segment-by-segment basis using a four-point confidence scale. The performance of the two combined MR sequence sets was evaluated using receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  The average area under the ROC curve (Az) of the three readers for the SPIO-enhanced MRI + DWI set (0.870 +/- 0.046) was significantly higher that that for the SPIO-enhanced MRI set (0.820 +/- 0.055) (P = .025). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detection of HCC were 66.0%, 98.0%, 90.0%, and 91.4%, respectively, for the SPIO-enhanced MRI set, and 70.0%, 98.6%, 92.9%, and 92.4%, respectively, for the SPIO-enhanced MRI + DWI set.
  
  
  CONCLUSIONS
  The SPIO-enhanced MRI + DWI set outperformed the SPIO-enhanced MRI set for depicting HCC.
authors.affiliation: Department of Clinical Radiology, Kyushu University, Fukuoka, Japan. anishie@radiol.med.kyushu-u.ac.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishie
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tajima
authors.forename: Kousei
authors.initials: K
authors.lastname: Ishigami
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ushijima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Okamoto
authors.forename: Masakazu
authors.initials: M
authors.lastname: Hirakawa
authors.forename: Yunosuke
authors.initials: Y
authors.lastname: Nishihara
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Hatakenaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Irie
authors.forename: Kengo
authors.initials: K
authors.lastname: Yoshimitsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005290:Ferric Compounds; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; C000499:ferric oxide