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Detection of small hypervascular hepatocellular carcinomas in cirrhotic patients: comparison of superparamagnetic iron oxide-enhanced MR imaging with dual-phase spiral CT.

Lee JM, Kim IH, Kwak HS, Youk JH, Han YM, Kim CS - Korean J Radiol (2003 Jan-Mar)

Bottom Line: The mean areas (Az) under the ROC curves were 0.85 for SPIOenhanced MR imaging and 0.79 for dual-phase spiral CT (p <.05).The mean sensitivity of SPIO-enhanced MR imaging was significantly higher than that of CT (p <.05), i.e. 70.6% for MR imaging and 58.1% for CT.MR imaging had higher false-positive rates than dual-phase spiral CT, but the difference was not statistically significant (3.7% vs 3.3%) (p >.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Seoul National University Hospital, Korea. leejm@radcom.snu.ac.kr

ABSTRACT

Objective: To compare the performance of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) maging at 1.5T and dual-phase spiral computed tomography (CT) for the depiction of small hypervascular hepatocellular carcinomas (HCCs).

Materials and methods: Forty-three patients with 70 small nodular HCCs (5-20 mm; mean, 13.7 mm) were examined. Diagnosis was based on the results of surgical biopsy in 22 patients and by the combined assessment of MR imaging, lipiodol CT, alpha feto-protein levels, and angiographic findings in 21. MR imaging consisted of respiratory-triggered turbo spin-echo T2-weighted imaging, T1-weighted fast low-angle shot, and T2* -weighted fast imaging with steady-state precession imaging before and after SPIO enhancement. CT imaging was performed with 5-mm collimation and 1:1.4 pitch, and began 30 and 65 secs after the injection of 150 mL of contrast medium at a rate of 3 mL/sec. Two blinded observers reviewed all images independently on a segment-by-segment basis. Diagnostic accuracy was evaluated using receiver operating characteristics(ROC) analysis.

Results: The mean areas (Az) under the ROC curves were 0.85 for SPIOenhanced MR imaging and 0.79 for dual-phase spiral CT (p <.05). The mean sensitivity of SPIO-enhanced MR imaging was significantly higher than that of CT (p <.05), i.e. 70.6% for MR imaging and 58.1% for CT. MR imaging had higher false-positive rates than dual-phase spiral CT, but the difference was not statistically significant (3.7% vs 3.3%) (p >.05).

Conclusion: SPIO-enhanced MR imaging is more sensitive than dual-phase spiral CT for the depiction of small hypervascular hepatocellular carcinomas.

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Related in: MedlinePlus

ROC curves describe observer confidence in the detection of hepatocellular carcinomas depicted at pre- and post-SPIO-enhanced MR imaging involving T1-weighted FLASH, T2-weighted TSE, and T2*-weighted FISP sequences (diamonds), and another set obtained at contrast-enhanced dual-phase spiral CT (squares). Note that observers showed more confidence in interpreting MR images than dual-phase spiral CT images (p < .05).
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Figure 1: ROC curves describe observer confidence in the detection of hepatocellular carcinomas depicted at pre- and post-SPIO-enhanced MR imaging involving T1-weighted FLASH, T2-weighted TSE, and T2*-weighted FISP sequences (diamonds), and another set obtained at contrast-enhanced dual-phase spiral CT (squares). Note that observers showed more confidence in interpreting MR images than dual-phase spiral CT images (p < .05).

Mentions: For all 70 lesions, the calculated areas under the ROC curves and the mean area for the two observers for each imaging modality are shown in Table 1. For each modality, ROC curves drawn on the basis of the data pooled by the two observers are shown in Figure 1. In terms of lesion detection, both agreed that performance using the set of SPIO-enhanced MR images was significantly superior to that obtained at dual-phase spiral CT imaging (p < .05). The mean area under both observers' ROC curves was 0.85 for pre- and post-SPIO-enhanced MR imaging and 0.79 for pre- and post-contrast dual-phase spiral CT imaging; this difference was statistically significant (p < .05).


Detection of small hypervascular hepatocellular carcinomas in cirrhotic patients: comparison of superparamagnetic iron oxide-enhanced MR imaging with dual-phase spiral CT.

Lee JM, Kim IH, Kwak HS, Youk JH, Han YM, Kim CS - Korean J Radiol (2003 Jan-Mar)

ROC curves describe observer confidence in the detection of hepatocellular carcinomas depicted at pre- and post-SPIO-enhanced MR imaging involving T1-weighted FLASH, T2-weighted TSE, and T2*-weighted FISP sequences (diamonds), and another set obtained at contrast-enhanced dual-phase spiral CT (squares). Note that observers showed more confidence in interpreting MR images than dual-phase spiral CT images (p < .05).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698053&req=5

Figure 1: ROC curves describe observer confidence in the detection of hepatocellular carcinomas depicted at pre- and post-SPIO-enhanced MR imaging involving T1-weighted FLASH, T2-weighted TSE, and T2*-weighted FISP sequences (diamonds), and another set obtained at contrast-enhanced dual-phase spiral CT (squares). Note that observers showed more confidence in interpreting MR images than dual-phase spiral CT images (p < .05).
Mentions: For all 70 lesions, the calculated areas under the ROC curves and the mean area for the two observers for each imaging modality are shown in Table 1. For each modality, ROC curves drawn on the basis of the data pooled by the two observers are shown in Figure 1. In terms of lesion detection, both agreed that performance using the set of SPIO-enhanced MR images was significantly superior to that obtained at dual-phase spiral CT imaging (p < .05). The mean area under both observers' ROC curves was 0.85 for pre- and post-SPIO-enhanced MR imaging and 0.79 for pre- and post-contrast dual-phase spiral CT imaging; this difference was statistically significant (p < .05).

Bottom Line: The mean areas (Az) under the ROC curves were 0.85 for SPIOenhanced MR imaging and 0.79 for dual-phase spiral CT (p <.05).The mean sensitivity of SPIO-enhanced MR imaging was significantly higher than that of CT (p <.05), i.e. 70.6% for MR imaging and 58.1% for CT.MR imaging had higher false-positive rates than dual-phase spiral CT, but the difference was not statistically significant (3.7% vs 3.3%) (p >.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Seoul National University Hospital, Korea. leejm@radcom.snu.ac.kr

ABSTRACT

Objective: To compare the performance of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) maging at 1.5T and dual-phase spiral computed tomography (CT) for the depiction of small hypervascular hepatocellular carcinomas (HCCs).

Materials and methods: Forty-three patients with 70 small nodular HCCs (5-20 mm; mean, 13.7 mm) were examined. Diagnosis was based on the results of surgical biopsy in 22 patients and by the combined assessment of MR imaging, lipiodol CT, alpha feto-protein levels, and angiographic findings in 21. MR imaging consisted of respiratory-triggered turbo spin-echo T2-weighted imaging, T1-weighted fast low-angle shot, and T2* -weighted fast imaging with steady-state precession imaging before and after SPIO enhancement. CT imaging was performed with 5-mm collimation and 1:1.4 pitch, and began 30 and 65 secs after the injection of 150 mL of contrast medium at a rate of 3 mL/sec. Two blinded observers reviewed all images independently on a segment-by-segment basis. Diagnostic accuracy was evaluated using receiver operating characteristics(ROC) analysis.

Results: The mean areas (Az) under the ROC curves were 0.85 for SPIOenhanced MR imaging and 0.79 for dual-phase spiral CT (p <.05). The mean sensitivity of SPIO-enhanced MR imaging was significantly higher than that of CT (p <.05), i.e. 70.6% for MR imaging and 58.1% for CT. MR imaging had higher false-positive rates than dual-phase spiral CT, but the difference was not statistically significant (3.7% vs 3.3%) (p >.05).

Conclusion: SPIO-enhanced MR imaging is more sensitive than dual-phase spiral CT for the depiction of small hypervascular hepatocellular carcinomas.

Show MeSH
Related in: MedlinePlus