Detection of hepatocellular carcinoma with Ferucarbotran (Resovist)-enhanced breath-hold MR imaging: Feasibility of 10 minute-delayed images

Abstract

Purpose: We evaluated the optimal timing for breath-hold MR imaging with bolus injectable superparamagnetic iron oxide (SPIO) for detecting hepatocellular carcinoma (HCC). Materials and Methods: Twenty patients with 62 HCCs (52 hypervascular, 10 non-hyper vascular) underwent MR imaging that included unenhanced and SPIO-enhanced T1 weighted gradient echo (GRE) and T2-weighted fast spin echo (FSE) sequences, perfusion study, and SPIO-enhanced T2*-weighted GRE sequences. We obtained SPIO-enhanced T2*-weighted sequences 10 and 30 min after injecting SPIO and made 2 image sets, comprising 10 or 30-min delayed T2*-weighted images. Three observers performed alternative free response receiver operating characteristic (AFROC) analysis, and quantitative evaluation was performed. Results: Only Observers 2 and 3 recognized a significant difference in the area under the AFROC curve (Az) value in the 10-min delayed images; no significant difference was observed in the 30-min delayed images. There was no significant difference in the sensitivity of individual observers between 10 and 30-min delayed images. The contrast-to-noise (C/N) ratio of the 30-min delayed images was significantly higher than that of the 10-min delayed images. The C/N ratio of hypervascular HCCs in the 30-min delayed images was significantly higher than in the 10-min delayed images, but that of non-hypervascular HCCs showed no significant difference. Conclusion: In most cases, 10-min delayed SPIO-enhanced T2*-weighted images are sufficient to detect HCCs.