Abstract 310: Detection of Hepatocellular Carcinoma in the Liver: Should Gadolinium-enhanced or SPIO-enhanced MR Imaging Be Preferred?
AUTHORS:
D.O. Pauleit, MD, R. Bachmann, MD, R. Conrad, MD, B.P. Kreft, MD, J. Textor, MD, H.H. Schild, MD, et al.
ABSTRACT:
PURPOSE: To compare superparamagnetic iron oxide (SPIO)-enhanced T2w TSE imaging for detection of hepatocellular carcinoma with dynamic gadolinium-enhanced T1w 3D-GRE imaging.
METHOD AND MATERIALS: On a 1.5T system 41 patients with chronic hepatitis (n=14) or liver cirrhosis (n=27) and a suspected HCC were examined using precontrast T1w FFE (TR/TE/a:130 ms/4,5 ms/80ç) and T2w TSE (2000 ms/60 ms/90ç) sequences. Within one week T2w TSE (2000 ms/60 ms/90ç) sequences after administration of SPIO and dynamic T1w 3D-TFE (7 ms/3 ms/20ç) sequences after administration of Gadolinium-DTPA were performed in the same patients to compare the lesion detectability of these sequences.
RESULTS: On the precontrast images 50/75 HCC were detected on T1w FFE and 59/75 on T2w TSE images. The average tumor size of the 75 lesions, which were proved to be HCC by biopsy or follow up, was 3.0 ± 2.5 cm (29 HCC 1.5 cm). The sensitivity of the dynamic Gd-enhanced T1w 3D-TFE sequence (68/75) was significantly higher than with SPIO-enhanced T2w TSE (59/75) sequence (p=0,042). Especially in lesions 1.5 cm Gd-enhanced T1w 3D-TFE sequence provided distinctly higher detectability of hepatocellular carcinoma compared with SPIO-enhanced T2w TSE sequences (26/29 vs 16/29, p=0.0036). 14 lesions were not detectable on precontrast images, 8/14 were only visible on dynamic Gd-enhanced T1w 3D-TFE images and 2/14 lesions were only seen on SPIO-enhanced T2w TSE images.
CONCLUSIONS: Gadolinium-enhanced dynamic T1w 3D-TFE sequences demonstrate a significantly higher sensitivity in detection of hepatocellular carcinoma than SPIO-enhanced T2w TSE sequences, especially in lesions 1.5 cm.
