Helmberger TK, Laubenberger J, Rummeny E, Jung G, Sievers K, Dohring W, Meurer K, Reiser MF.MRI characteristics in focal hepatic disease before and after administration of MnDPDP: discriminant analysis as a diagnostic tool.: Eur Radiol. 2002 Jan;12(1):62-70. Epub 2001 Oct 19.
The aim of this
study was to determine if different types of focal hepatic lesions
can be differentiated by specific quantitative and qualitative
imaging characteristics pre- and post-Mangafodipir trisodium (MnDPDP)
administration using a computerized multivariable, discriminant
analysis (DA). In a multicenter trial, 151 patients with focal
liver disease were studied at 1.5 and 1.0 T using gradient-recalled
echo T1 and fast spin-echo T2-weighted images pre and post MnDPDP
(0.005 mmol/ kg b.w.) i.v. administration. Analysis could be performed
in 141 of 151 of the patients. The variables used in both single
variable analysis and DA included contrast-to-noise ratios pre
and post MnDPDP, presence of rim enhancement, margin, and heterogeneity
of a lesion pre and post MnDPDP. The classification of diagnoses
using DA was compared with a standard of reference (HCC in 23%,
metastases in 25%, cyst in 13%, FNH in 10%, hemangioma in 11%,
and other or no lesion in 18% of the patients; histology in 49%,
long-term follow-up in 51% of the cases). In the differentiation
of the various hepatic lesions, CNR together with the presence
of heterogeneity or rim enhancement as variables for DA gave the
highest sensitivity, specificity, and accuracy which ranged between
65 and 93, 44 and 83, and 65 and 86%, respectively. The DA models
based on post-MnDPDP variables showed better classification results
than the models based on pre-MnDPDP variables. An improvement
of accuracy was observed when differentiating HCC from FNH lesion
groups (48.9-67.4%; p < or = 0.05), and when differentiating
HCC from metastasis lesion groups (68.3-84.1%; p < or = 0.01).
In all regards there was no difference for T2-weighted images
pre and post MnDPDP. By combining quantitative and qualitative
variables, DA proved to be a useful tool in lesion discrimination.
Due to considerable heterogeneity within some of the lesion type
groups, the definite diagnostic impact of MnDPDP cannot be completely
established yet, and further investigation is still necessary.
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