Kim SK, Kim SH, Lee WJ, Kim H, Seo JW, Choi D, Lim HK, Lee SJ, Lim JH.: Preoperative detection of hepatocellular carcinoma: ferumoxides-enhanced versus mangafodipir trisodium-enhanced MR imaging.AJR Am J Roentgenol. 2002 Sep;179(3):741-50. n-Dong, Kangnam-Ku, Seoul 135-710, Korea.
OBJECTIVE: The
purpose of our study was to compare the diagnostic accuracy and
lesion conspicuity of ferumoxides-enhanced MR imaging with those
of mangafodipir trisodium-enhanced MR imaging for the preoperative
detection of hepatocellular carcinoma. SUBJECTS AND METHODS: Twenty-one
patients with 39 hepatocellular carcinomas underwent ferumoxides-enhanced
and mangafodipir trisodium-enhanced MR imaging. The diagnosis
was established by pathologic examination after surgical resection
in all patients. Five MR sequences were obtained 30 min after
ferumoxides administration, and two MR sequences were obtained
before and 15 min after mangafodipir trisodium administration.
Three observers independently interpreted both MR images of all
sequences on a segment-by-segment basis. The diagnostic accuracy
of MR imaging was assessed using receiver operating characterizing
analysis. Lesion (hepatocellular carcinoma > 10 mm in diameter)-to-liver
contrast-to-noise ratio was calculated on MR images. RESULTS:
Ferumoxides-enhanced MR imaging (A(z) = 0.971) was significantly
more accurate (p < 0.05) than mangafodipir trisodium-enhanced
MR imaging (A(z) = 0.950). The mean sensitivity of ferumoxides-enhanced
MR imaging (86%) was significantly greater (p < 0.05) than
that of mangafodipir trisodium-enhanced MR imaging (44%) in lesions
smaller than 10 mm. The mean lesion-to-liver contrast-to-noise
ratio of hepatocellular carcinoma on ferumoxides-enhanced MR imaging
(13.7 +/- 8.8) was significantly greater than on mangafodipir
trisodium-enhanced MR imaging (5.4 +/- 5.1) (p < 0.01). CONCLUSION:
Ferumoxides-enhanced MR imaging has superior diagnostic accuracy
in lesions smaller than 10 mm and superior lesion conspicuity
compared with mangafodipir trisodium-enhanced MR imaging for the
preoperative detection of hepatocellular carcinoma.
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