Characterization of Focal Hepatic Lesions with Ferumoxides-Enhanced T2-Weighted MR Imaging

Paley, Mark R.; Mergo, Patricia J.; Torres, Gladys M.; Ros, Pablo R.

doi:10.2214/ajr.175.1.1750159

Cited by 72 publications

(47 citation statements)

References 13 publications

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“…In SPIO-enhanced MRI, it is possible to differentiate benign from malignant focal lesions on the basis of their cellular composition and function [10]. Typically, malignant liver lesions that are devoid of Kupffer cells, such as metastatic lesions or cholangiocarcinoma, appear as hyperintense lesions without significant signal intensity loss against the dark background of liver on SPIOenhanced MRI.…”

Section: Discussionmentioning

confidence: 99%

Percentage of signal intensity loss for characterisation of focal liver lesions in patients with chronic liver disease using ferucarbotran-enhanced MRI

Ct¹,

Rc²,

Chen³

et al. 2010

BJR

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ABSTRACT. The purpose of this study was to determine the percentage of signal intensity loss (PSIL) threshold for the characterisation of focal liver lesions among patients with chronic liver disease. 55 nodules in 49 patients with chronic liver disease who underwent ferucarbotran-enhanced MR studies were included. Among the 49 patients, 40 had liver cirrhosis and 9 had chronic hepatitis. 8 haemangiomas, 3 focal nodular hyperplasia, 9 dysplastic nodules and 12 well, 19 moderately and 4 poorly differentiated hepatocellular carcinomas (HCCs) were revealed. The PSIL, signal-to-noise ratio and contrast-to-noise ratio of each lesion type were calculated. The diagnostic performance of PSIL on ferucarbotran-enhanced T 2 weighted images (PSIL T2WI ) and T 2 weighted fat-suppression images (PSIL FS-T2WI ) that characterised hepatic tumours was compared with receiver operating characteristic (ROC) analysis. Using ROC analysis, the diagnostic performance of PSIL FS-T2WI was superior to that of PSIL T2WI (p50.01). The mean PSIL FS-T2WI of the benign lesions was significantly higher than that of HCC (p,0.001), and the mean PSIL FS-T2WI of well-differentiated HCC was significantly higher than that of moderately/poorly differentiated HCCs (p50.001). With a PSIL FS-T2WI threshold of 40% in lesions characterising ferucarbotran-enhanced FS-T2WI, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 88.6%, 95%, 90.9%, 96.9% and 82.6%, respectively. In conclusion, with ferucarbotran-enhanced FS-T2WI, a PSIL FS-T2WI threshold of 40% for characterising focal liver nodules among patients with chronic liver disease is recommended. It is useful for distinguishing HCC from benign nodules.

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Section: Discussionmentioning

confidence: 99%

Percentage of signal intensity loss for characterisation of focal liver lesions in patients with chronic liver disease using ferucarbotran-enhanced MRI

Ct¹,

Rc²,

Chen³

et al. 2010

BJR

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“…Ayrıca fokal karaciğer lezyonlarında ferrumoksit ile sinyal intensite ve lezyon-karaciğer kontrast değişik-liklerine bakarak MRG'nin benign ve malign lezyonları karakterize etmede faydalı olup olmayacağını araştırılmıştır. Bunlara göre T2A sekanslarda SPFeO'nun özellikle tümör-karaciğer kontrastını artırarak MRG'nin lezyon saptamadaki başarısını arttırdığı gösterilmiştir (13). Ayrıca kontrastsız MR görüntüle-me ya da kontrastlı BT incelemede saptanamayan milimetrik boyutlardaki lezyonların SPFeO sonrası MR görüntüleme ile tespit edilebildiğini iddia eden yayınlar mevcuttur.…”

Section: Discussionunclassified

Superparamagnetic Iron Oxide Enhanced Magnetic Resonance Imaging In The Detection Of Malignant Liver Lesions

Çağlı¹,

Temízöz²,

Gençhellaç³

et al. 2010

TUTFD

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ÖZETAmaç: Manyetik Rezonans (MR) görüntülemede kontrast madde olarak kullanılan süperparamanyetik demir oksit (SPFeO) preparatının malign karaciğer kitlelerinin tanısındaki yerini araştırmaktır. Gereç ve Yöntemler:Değişik tipte karaciğer kitleleri bulunan 20 olguya 1 Tesla cihaz ile MR inceleme yapıldı. Olgulara pre-ve post-kontrast T1-ağırlıklı FLASH (Fast Low Angle Shot) ve çift eko TSE (Turbo Spin Echo) T2-ağırlıklı sekanslar uygulandı. Lezyonlardan yapılan sinyal intensite öl-çümlerine göre "Tanımlayıcı istatistikler" yapıldı.Bulgular: Onbir olguda metastaz, 4 olguda hemanjiom, 4 olguda HCC (Hepatosellüler Karsinom) ve 1 olguda ise birer adet hemanjiom ve metastaz bulundu. Sadece hemanjiom saptanan olgularda tüm sekanslarda S/N oranlarında anlamlı değişim (p=0.043) saptanırken, çift eko TSE T2A sekansda sadece uzun TE'de Sİ değişimi (p=0.043) anlamlı bulundu. Metastaz ve HCC olgularında çift eko TSE T2A sekansda kısa TE'de diğer sekanslara oranla C/N oranlarında belirgin yüzde artış saptanırken, hemanjiom olgularında ise kontrast sonrasında özellikle çift eko TSE T2A sekansda uzun TE'de C/N oranlarında azalma belirlendi.Sonuç: Karaciğerde gerek lezyon tespiti ve sayısının belirlenmesi, gerekse benign (özellikle hemanjiom), primer ya da metastatik malignite ayrımında SPFeO ile MR görüntüleme diğer sekanslara ek bulgular sağlayan noninvaziv bir radyolojik metod olarak kullanılabilir. Materials and Methods:Twenty patients with various hepatic masses or metastases were investigated with 1 tesla MR. T1-weighted FLASH and double-echo TSE T2-weighted sequences were applied before and after contrast injection. "Defining statistics" were prepared according to pre and postcontrast signal intensity measurements.Results: In this study there were 11 patients with metastases, 4 patients with hemangioma, 4 patients with HCC and one patient with a hemangioma and a metastasis at the same time. In cases wheret we found only hemangiomas, in all sequences, S/N ratios (p=0.043) and T2-weighted double-echo TSE with long TE SI change (p=0.043) were significant. While in the hemangiomas in T2-weighted double-echo TSE with long TE there is an decrease in the C/N ratios; in cases with metastasis and HCC, compared to other sequences significant increase in C/N ratio in T2-weighted double-echo TSE with short TE sequences was detected.Conclusion: SPIO-enhanced MR imaging can be used as a non-invasive radiologic technique for the detection focal liver lesions, to determine the number of lesions and also has a value in differentiating the benign lesions (especially hemangiomas) from primary tumors or metastatic malignant lesions.Key Words: Superparamagnetic iron oxide (SPIO), Contrast-Noise Ratio, MR imaging, T1-weighted FLASH and T2-weighted double-echo TSE sequences : 15.02.2010: 15.02. Accepted: 31.05.2010 Giriş Karaciğer görüntülemesinde manyetik rezonans (MR) inceleme artık önemli bir radyolojik modalite olarak yerini almıştır. Özellikle bilgisayarlı tomografi (BT) ve ultrasonografi (US) gibi diğer modalitelerin yetersiz kaldığı o...

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“…Ferucarbotran has an advantage over ferumoxides (Feridex, Advanced Magnetics; Guerbet), which is the only marketed SPIO in most countries. Although it is well known that ferumoxides have relatively high R1 values (up to four or five times higher than those of gadolinium-based contrast agents) [10,25,26] , these T1 effects cannot be readily exploited for dynamic T1-weighted MR imaging. Bolus administration of ferumoxides has not been recommended because of the possible side effects (lumbar pain and cardiovascular problems, including dosedependent hypotensive reactions) that positively correlate to the rate of injection; therefore, this compound must be administered as a slow drip infusion [13] .…”

Section: Discussionmentioning

confidence: 99%

FerucarbotranversusGd-DTPA-enhanced MR imaging in the detection of focal hepatic lesions

Cheng

Zeng²,

Yan³

et al. 2007

WJG

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Characterization of Focal Hepatic Lesions with Ferumoxides-Enhanced T2-Weighted MR Imaging

Cited by 72 publications

References 13 publications

Percentage of signal intensity loss for characterisation of focal liver lesions in patients with chronic liver disease using ferucarbotran-enhanced MRI

Percentage of signal intensity loss for characterisation of focal liver lesions in patients with chronic liver disease using ferucarbotran-enhanced MRI

Superparamagnetic Iron Oxide Enhanced Magnetic Resonance Imaging In The Detection Of Malignant Liver Lesions

FerucarbotranversusGd-DTPA-enhanced MR imaging in the detection of focal hepatic lesions

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