Original Research

Detection of hepatocellular carcinoma (HCC) using super paramagnetic iron oxide (SPIO)-enhanced MRI: Added value of diffusion-weighted imaging (DWI)

  1. Akihiro Nishie MD1,*,
  2. Tsuyoshi Tajima MD1,
  3. Kousei Ishigami MD1,
  4. Yasuhiro Ushijima MD1,
  5. Daisuke Okamoto MD1,
  6. Masakazu Hirakawa MD1,
  7. Yunosuke Nishihara MD2,
  8. Akinobu Taketomi MD3,
  9. Masamitsu Hatakenaka MD1,
  10. Hiroyuki Irie MD1,
  11. Kengo Yoshimitsu MD1,
  12. Hiroshi Honda MD1

Article first published online: 23 JAN 2010

DOI: 10.1002/jmri.22059

Issue

Journal of Magnetic Resonance Imaging

Journal of Magnetic Resonance Imaging

Volume 31, Issue 2, pages 373–382, February 2010

Additional Information

How to Cite

Nishie, A., Tajima, T., Ishigami, K., Ushijima, Y., Okamoto, D., Hirakawa, M., Nishihara, Y., Taketomi, A., Hatakenaka, M., Irie, H., Yoshimitsu, K. and Honda, H. (2010), Detection of hepatocellular carcinoma (HCC) using super paramagnetic iron oxide (SPIO)-enhanced MRI: Added value of diffusion-weighted imaging (DWI). J. Magn. Reson. Imaging, 31: 373–382. doi: 10.1002/jmri.22059

Author Information

  1. 1

    Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

  2. 2

    Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

  3. 3

    Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

*Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka, 812-8582, Japan

Publication History

  1. Issue published online: 23 JAN 2010
  2. Article first published online: 23 JAN 2010
  3. Manuscript Accepted: 2 NOV 2009
  4. Manuscript Received: 27 MAR 2009

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Keywords:

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

Abstract

Purpose:

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.

Results:

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.

Conclusion:

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.

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