Using Superparamagnetic Iron Oxide–Enhanced MRI to Differentiate Metastatic Hepatic Tumors and Nonsolid Benign Lesions

Kumano, Seishi; Murakami, Takamichi; Kim, Tonsok; Hori, Masatoshi; Okada, Atsuya; Sugiura, Toshihiro; Noguchi, Yukiko; Kawata, Seiichi; Tomoda, Kaname; Nakamura, Hajime

doi:10.2214/ajr.181.5.1811335

Cited by 47 publications

(37 citation statements)

References 18 publications

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“…No signiˆcant diŠerence was seen in the ADC measurements of the pancreas and right and left kidneys. Superparamagnetic iron oxide (SPIO) 6,[21][22][23][24][25][26][27][28][29] With the application of diŠusion gradients in liver imaging, signals from vascular structures and simple liver cysts can be reduced, allowing easier detection of liver lesions without the distraction of possible pseudo-lesions, such as those commonly observed on SPIO-enhanced T2 * -weighted images. Two problems are reported for non-SPIO-mediated DWI.…”

Section: Measuring Adcmentioning

confidence: 99%

Diffusion-weighted Imaging of the Liver: Technical Challenges and Prospects for the Future

Naganawa¹,

Kawai²,

Fukatsu³

et al. 2005

MRMS

136

133

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DiŠusion-weighted imaging (DWI) has recently been attempted in the abdominal region. We review diŠusion-weighted images of the liver, especially from the technical point of view. We discuss selection of pulse sequence parameters, eŠects of anti-breathing motion technique, tips for measuring apparent diŠusion coe‹cient (ADC), and utility of superparamagnetic iron oxide (SPIO), showing clinical cases, including those at 3T. Our current trial of new pulse sequencing, such as SPIO-mediated breath-holding black-blood ‰uid-attenuated inversion recovery (BH-BB-FLAIR), imaging is shown. Some prospects for the future in DWI of the liver are also stated.

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Section: Measuring Adcmentioning

confidence: 99%

Diffusion-weighted Imaging of the Liver: Technical Challenges and Prospects for the Future

Naganawa¹,

Kawai²,

Fukatsu³

et al. 2005

MRMS

136

133

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“…It is our opinion that ferucarbotranenhanced dynamic MR imaging with T2-weighted echoplanar sequence is hardly used to differentiate cysts from other focal lesions. For that purpose, the charac- teristic signal-intensity pattern on T2-weighted and heavily T1-weighted images (12) or ring enhancement on heavily T1-weighted images (13) could be helpful. In contrast, with regard to hemangiomas, a characteristic enhancement pattern was observed.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic characterization of focal hepatic lesions: Role of ferucarbotran‐enhanced dynamic MR imaging using T2‐weighted multishot spin‐echo echo‐planar sequence

Hori

Murakami

Kim

et al. 2006

Magnetic Resonance Imaging

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Purpose:To investigate the role of ferucarbotran-enhanced dynamic MR imaging using multishot spin-echo echo-planar sequence in the evaluation of hemodynamics of focal hepatic lesions. Materials and Methods:Sixty-three focal hepatic lesions (24 benign and 39 malignant) from 53 consecutive patients who underwent both ferucarbotran-enhanced MR imaging and dynamic computed tomography (CT) were included in this study. MR imaging was performed with a 1.5-T scanner with a phased-array coil. T2-weighted multishot spin-echo echo-planar sequences (TR/TE ϭ 1714 -2813/80 msec) were obtained during a single breathhold before and 15, 60, 120, 180, and 600 seconds after intravenous injection of ferucarbotran. The enhancement patterns of lesions were classified into three categories by a study coordinator on the basis of dynamic CT images as hypervascular, hypovascular, and hemangioma type. The study coordinator created mean contrast-to-noise ratio of lesions vs. time curves for each enhancement pattern for quantitative analyses. Moreover, three radiologists separately and blindly reviewed MR images, and then assigned three confidence scores for the three enhancement patterns to each lesion. Sensitivity, specificity, and receiver operating characteristic analyses were performed. Results:Quantitative analyses showed characteristic enhancement curves for each enhancement pattern. Mean sensitivities/specificities were 0.816/0.882, 0.897/0.863, and 0.800/0.989 for hypervascular, hypovascular, and hemangioma types, respectively. Mean areas under the receiver operating characteristic curve were 0.886 for hypervascular type and 0.913 for hypovascular type. Conclusion:Ferucarbotran-enhanced dynamic MR imaging can be used to successfully characterize the hemodynamics of focal hepatic lesions.

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“…Table 6 Quantitative Assessment of Liver and Spleen SNR and Lesion-to-Liver CNR GRASE can be used in combination with other techniques. The use of SPIO administration can improve the detectability of malignant hepatic lesions on T2-weighted and T2*-weighted images (25,26). Some investigators reported that the T2*-weighted GRE technique was superior to T2-weighted SE, fast SE, and HASTE for the detection of malignant liver tumor after administration of SPIO (25,26).…”

Section: Discussionmentioning

confidence: 99%

“…The use of SPIO administration can improve the detectability of malignant hepatic lesions on T2-weighted and T2*-weighted images (25,26). Some investigators reported that the T2*-weighted GRE technique was superior to T2-weighted SE, fast SE, and HASTE for the detection of malignant liver tumor after administration of SPIO (25,26). The higher susceptibility contrast of GRASE resulting from the use of additional gradient echoes is a potentially desirable attribute for use with SPIO enhancement.…”

Section: Discussionmentioning

confidence: 99%

Focal liver lesions: Breathhold gradient‐ and spin‐echo T2‐weighted imaging for detection and characterization

Yoshikawa

Mitchell

Hirota

et al. 2006

Magnetic Resonance Imaging

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Purpose:To evaluate breathhold gradient-and spin-echo (GRASE) T2-weighted imaging for the detection and characterization of focal liver lesions. Materials and Methods:Two GRASE sequences with different echo times (75 and 90 msec, GRASE 75 and GRASE 90 ) were compared with respiratory-triggered fast spin-echo (SE) and breathhold fast SE in 64 patients with 103 malignant and 51 benign lesions. Compared with respiratorytriggered and breathhold fast SE, GRASE reduced scan time by 77% to 82% and 21% to 27%, respectively. Two independent readers evaluated image quality and reviewed 504 liver segments on a segment-by-segment basis. Observer performance was evaluated with receiver operating characteristic (ROC) curve analysis. The signal-to-noise ratio (SNR) of liver and spleen, and lesion-to-liver contrastto-noise ratio (CNR) were also measured. Results:The overall quality of the GRASE images was higher than that of the respiratory-triggered and breathhold fast SE images, although signal inhomogeneities were more frequently observed with GRASE. No significant difference in the values of the area under the ROC curve (Az) for malignant lesion detection was found. The mean SNR and CNR were highest for respiratory-triggered fast SE.Conclusion: T2-weighted breathhold GRASE has the potential to provide faster liver imaging.

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Using Superparamagnetic Iron Oxide–Enhanced MRI to Differentiate Metastatic Hepatic Tumors and Nonsolid Benign Lesions

Abstract: When evaluating metastatic liver tumors on SPIO-enhanced MRI, we recommend that heavily T1- and T2-weighted gradient-echo images be obtained with our parameters to exclude hemangiomas or cysts.

Cited by 47 publications

References 18 publications

Diffusion-weighted Imaging of the Liver: Technical Challenges and Prospects for the Future

Diffusion-weighted Imaging of the Liver: Technical Challenges and Prospects for the Future

Hemodynamic characterization of focal hepatic lesions: Role of ferucarbotran‐enhanced dynamic MR imaging using T2‐weighted multishot spin‐echo echo‐planar sequence

Focal liver lesions: Breathhold gradient‐ and spin‐echo T2‐weighted imaging for detection and characterization

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