Matsuo M, Kanematsu M, Itoh K, Ito K, Maetani Y, Kondo H, Kako N, Matsunaga N, Hoshi H, Shiraishi J. Detection of malignant hepatic tumors: comparison of gadolinium-and ferumoxide-enhanced MR imaging. AJR Am J Roentgenol 2001 Sep;177(3):637-43
OBJECTIVE: The purpose of
our study was to compare how well gadolinium-enhanced and ferumoxide-enhanced
MR imaging reveal malignant hepatic tumors. SUBJECTS AND METHODS:
Both gadolinium-enhanced and ferumoxide-enhanced MR imaging were
separately performed in 53 patients with a total of 87 malignant
hepatic tumors (57 hepatocellular carcinomas, 28 metastases, two
cholangiocarcinomas). Thirty-one of the 53 patients had hepatic
cirrhosis. Images were reviewed by three independent off-site
observers. Observer performance was evaluated by means of sensitivity,
specificity, and receiver operating characteristic curve analyses.
RESULTS: Gadolinium-enhanced MR imaging outperformed ferumoxide-enhanced
MR imaging in sensitivity (81% versus 62%, p < 0.01) for malignant-tumor
detection. Specificity was comparable (94%) between the two types
of MR imaging. Area under receiver operating characteristic curve
(A(z)) value was significantly higher with gadolinium-enhanced
MR imaging than with ferumoxide-enhanced MR imaging in patients
overall (A(z) = 0.896 versus 0.805, p < 0.001), in patients
with cirrhosis (A(z) = 0.907 versus 0.807, p < 0.001), and
in patients without cirrhosis (A(z) = 0.899 versus 0.834, p <
0.01). The superiority was enhanced in the subset of patients
with cirrhosis. CONCLUSION: Gadolinium-enhanced MR imaging outperforms
ferumoxide-enhanced MR imaging in revealing malignant hepatic
tumors. Gadolinium-enhanced MR imaging is recommended, particularly
for patients with cirrhosis.
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