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  • Title: Detection of malignant hepatic tumors: comparison of gadolinium-and ferumoxide-enhanced MR imaging.
    Author: Matsuo M, Kanematsu M, Itoh K, Ito K, Maetani Y, Kondo H, Kako N, Matsunaga N, Hoshi H, Shiraishi J.
    Journal: AJR Am J Roentgenol; 2001 Sep; 177(3):637-43. PubMed ID: 11517061.
    Abstract:
    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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