• hepatocellular carcinoma;
  • MRI;
  • diffusion-weighted imaging;
  • super paramagnetic iron oxide;
  • liver



To evaluate whether diffusion-weighted imaging (DWI) improves the detection of hepatocellular carcinoma (HCC) on super paramagnetic iron oxide (SPIO)-enhanced MRI.

Materials and Methods:

This retrospective study group consisted of 30 patients with 50 HCC nodules who underwent MRI at 1.5 Tesla. Two combined MR sequence sets were compared for detecting HCC: SPIO-enhanced MRI (axial T2-weighted fast spin-echo (FSE) and T1-/T2*-weighted fast field echo (FFE) scanned before and after administration of ferucarbotran) and SPIO-enhanced MRI + DWI (SPIO-enhanced MRI with axial DWI scanned before and after administration of ferucarbotran). Three blinded readers independently reviewed for the presence of HCC on a segment-by-segment basis using a four-point confidence scale. The performance of the two combined MR sequence sets was evaluated using receiver operating characteristic (ROC) analysis.


The average area under the ROC curve (Az) of the three readers for the SPIO-enhanced MRI + DWI set (0.870 ± 0.046) was significantly higher that that for the SPIO-enhanced MRI set (0.820 ± 0.055) (P = .025). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detection of HCC were 66.0%, 98.0%, 90.0%, and 91.4%, respectively, for the SPIO-enhanced MRI set, and 70.0%, 98.6%, 92.9%, and 92.4%, respectively, for the SPIO-enhanced MRI + DWI set.


The SPIO-enhanced MRI + DWI set outperformed the SPIO-enhanced MRI set for depicting HCC. J. Magn. Reson. Imaging 2010; 31: 373–382. © 2010 Wiley-Liss, Inc.