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Lu CH, Hsiao JK. Diagnostic and therapeutic roles of iron oxide nanoparticles in biomedicine. Tzu Chi Med J 2022; 35:11-17. [PMID: 36866343 PMCID: PMC9972926 DOI: 10.4103/tcmj.tcmj_65_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/03/2022] [Accepted: 06/08/2022] [Indexed: 11/04/2022] Open
Abstract
Nanotechnology changed our understanding of physics and chemics and influenced the biomedical field. Iron oxide nanoparticles (IONs) are one of the first emerging biomedical applications of nanotechnology. The IONs are composed of iron oxide core exhibiting magnetism and coated with biocompatible molecules. The small size, strong magnetism, and biocompatibility of IONs facilitate the application of IONs in the medical imaging field. We listed several clinical available IONs including Resovist (Bayer Schering Pharma, Berlin, Germany) and Feridex intravenous (I.V.)/Endorem as magnetic resonance (MR) contrast agents for liver tumor detection. We also illustrated GastroMARK as a gastrointestinal contrast agent for MR imaging. Recently, IONs named Feraheme for treating iron-deficiency anemia have been approved by the Food and Drug Administration. Moreover, tumor ablation by IONs named NanoTherm has also been discussed. In addition to the clinical application, several potential biomedical applications of IONs including cancer-targeting capability by conjugating IONs with cancer-specific ligands, cell trafficking tools, or tumor ablation agents have also been discussed. With the growing awareness of nanotechnology, further application of IONs is still on the horizon that would shed light on biomedicine.
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Affiliation(s)
- Chia-Hung Lu
- Department of Medical Imaging, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Jong-Kai Hsiao
- Department of Medical Imaging, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan,School of Medicine, Tzu Chi University, Hualien, Taiwan,Address for correspondence: Dr. Jong-Kia Hsiao, Department of Medical Imaging, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 289, Jianguo Road, Xindian District, New Taipei, Taiwan. E-mail:
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Qin XY, Liu XX, Li ZY, Guo LY, Zheng ZZ, Guan HT, Song L, Zou YH, Fan TY. MRI Detectable Polymer Microspheres Embedded With Magnetic Ferrite Nanoclusters For Embolization: In Vitro And In Vivo Evaluation. Int J Nanomedicine 2019; 14:8989-9006. [PMID: 31819414 PMCID: PMC6873973 DOI: 10.2147/ijn.s209603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 09/25/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The objective of this study was to develop magnetic embolic microspheres that could be visualized by clinical magnetic resonance imaging (MRI) scanners aiming to improve the efficiency and safety of embolotherapy. METHODS AND DISCUSSION Magnetic ferrite nanoclusters (FNs) were synthesized with microwave-assisted solvothermal method, and their morphology, particle size, crystalline structure, magnetic properties as well as T2 relaxivity were characterized to confirm the feasibility of FNs as an MRI probe. Magnetic polymer microspheres (FNMs) were then produced by inverse suspension polymerization with FNs embedded inside. The physicochemical and mechanical properties (including morphology, particle size, infrared spectra, elasticity, etc.) of FNMs were investigated, and the magnetic properties and MRI detectable properties of FNMs were also assayed by vibrating sample magnetometer and MRI scanners. Favorable biocompatibility and long-term MRI detectability of FNMs were then studied in mice by subcutaneous injection. FNMs were further used to embolize rabbits' kidneys to evaluate the embolic property and detectability by MRI. CONCLUSION FNMs could serve as a promising MRI-visualized embolic material for embolotherapy in the future.
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Affiliation(s)
- Xiao-Ya Qin
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Xiao-Xin Liu
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Zi-Yuan Li
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Li-Ying Guo
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
| | - Zhuo-Zhao Zheng
- Department of Nuclear Medicine, Beijing Tsinghua Changgung Hospital, Beijing, People’s Republic of China
| | - Hai-Tao Guan
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, People’s Republic of China
| | - Li Song
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, People’s Republic of China
| | - Ying-Hua Zou
- Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, Beijing, People’s Republic of China
| | - Tian-Yuan Fan
- The State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
- Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery Systems, School of Pharmaceutical Sciences, Peking University, Beijing, People’s Republic of China
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Zarghami N, Khrapitchev AA, Perez-Balderas F, Soto MS, Larkin JR, Bau L, Sibson NR. Optimization of molecularly targeted MRI in the brain: empirical comparison of sequences and particles. Int J Nanomedicine 2018; 13:4345-4359. [PMID: 30100719 PMCID: PMC6064157 DOI: 10.2147/ijn.s158071] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Molecular MRI is an evolving field of research with strong translational potential. Selection of the appropriate MRI sequence, field strength and contrast agent depend largely on the application. The primary aims of the current study were to: 1) assess the sensitivity of different MRI sequences for detection of iron oxide particles in mouse brain; 2) determine the effect of magnetic field strength on detection of iron oxide particles in vivo; and 3) compare the sensitivity of targeted microparticles of iron oxide (MPIO) or ultra-small superparamagnetic iron oxide (USPIO) for detection of vascular cell adhesion molecule-1 (VCAM-1) in vivo. METHODS Mice were injected intrastriatally with interleukin 1β to induce VCAM-1 expression on the cerebral vasculature. Subsequently, animals were injected intravenously with either VCAM-MPIO or VCAM-USPIO and imaged 1 or 13 hours post-injection, respectively. MRI was performed at 4.7, 7.0, or 9.4 T, using three different T2*-weighted sequences: single gradient echo 3D (GE3D), multi-gradient echo 3D (MGE3D) and balanced steady-state free precession 3D (bSSFP3D). RESULTS MGE3D yielded the highest signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for the detection of iron oxide particles. All sequences showed a significant increase in SNR and CNR from 4.7 to 7.0 T, but no further improvement at 9.4 T. However, whilst targeted MPIO enabled sensitive detection of VCAM-1 expression on the cerebral vasculature, the long half-life (16.5 h vs 1.2 min) and lower relaxivity per particle (1.29×10-14 vs 1.18×10-9 Hz L/particle) of USPIO vs. MPIO rendered them impractical for molecular MRI. CONCLUSION These findings demonstrate clear advantages of MPIO compared to USPIO for molecularly-targeted MRI, and indicate that the MGE3D sequence is optimal for MPIO detection. Moreover, higher field strengths (7.0/9.4 T) showed enhanced sensitivity over lower field strengths (4.7 T). With the development of biodegradable MPIO, these agents hold promise for clinical translation.
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Affiliation(s)
- Niloufar Zarghami
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Alexandre A Khrapitchev
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Francisco Perez-Balderas
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Manuel Sarmiento Soto
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - James R Larkin
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
| | - Luca Bau
- Institute of Biomedical Engineering, Department of Engineering Sciences, University of Oxford, Oxford, UK
| | - Nicola R Sibson
- Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, UK,
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Tanabe M, Ito K, Shimizu A, Fujita T, Onoda H, Yamatogi S, Washida Y, Matsunaga N. Hepatocellular lesions with increased iron uptake on superparamagnetic iron oxide-enhanced magnetic resonance imaging in cirrhosis or chronic hepatitis: comparison of four magnetic resonance sequences for lesion conspicuity. Magn Reson Imaging 2009; 27:801-6. [DOI: 10.1016/j.mri.2008.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 10/08/2008] [Accepted: 11/10/2008] [Indexed: 10/21/2022]
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Kim YK, Lee YH, Kwak HS, Kim CS, Han YM. Small malignant hepatic tumor detection in gadolinium- and ferucarbotran-enhanced magnetic resonance imaging: does combining ferucarbotran-enhanced T2*-weighted gradient echo and T2-weighted turbo spin echo images have additive efficacy? Korean J Radiol 2009; 9:510-9. [PMID: 19039267 PMCID: PMC2627240 DOI: 10.3348/kjr.2008.9.6.510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Objective To determine if a combination of ferucarbotran-enhanced T2*weighted-gradient echo (T2*W-GRE) and T2-weighted turbo spin echo (T2W-TSE) images in gadolinium- and ferucarbotran-enhanced MRI has additive efficacy compared to each image alone for detecting small (≤ 2.0 cm) hepatocellular carcinoma (HCC) lesions in a group of cirrhotic patients and metastases in a group of non-cirrhotic patients. Materials and Methods Two readers retrospectively analyzed gadolinium- and ferucarbotran-enhanced T2*W-GRE, T2W-TSE, and combined T2*W-GRE/T2W-TSE images of 119 patients with 157 HCCs and 32 patients with 98 metastases. The diagnostic accuracy and sensitivity for each image set and the combined set were evaluated using the alternative-free response receiver operating characteristic method. Results The mean area under the curve value of the combined set (0.966) tended to be better than that for each individual image set (T2W-TSE [0.910], T2*W-GRE [0.892]). Sensitivities in the combined set were higher than those in each individual image set for detecting HCC (mean, 93.0% versus 81.6% and 86.7%, respectively, p < 0.01). Sensitivities in the combined set and the T2W-TSE set were the same for detecting metastases, and both were higher than the sensitivity seen in the T2*W-GRE set (mean, 97.5% versus 85.2%, p < 0.01). Conclusion Combining ferucarbotran-enhanced T2*W-GRE and T2W-TSE has additive efficacy for detecting HCC in cirrhotic patients, but T2W-TSE is preferred for detecting metastases in non-cirrhotic patients.
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Affiliation(s)
- Young Kon Kim
- Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Chonbuk, Korea.
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Ishiyama K, Hashimoto M, Izumi JI, Watarai J, Shibata S, Sato T, Yamamoto Y. Tumor-liver contrast and subjective tumor conspicuity of respiratory-triggered T2-weighted fast spin-echo sequence compared with T2*-weighted gradient recalled-echo sequence for ferucarbotran-enhanced magnetic resonance imaging of hepatic malignant tumors. J Magn Reson Imaging 2008; 27:1322-6. [PMID: 18504744 DOI: 10.1002/jmri.21399] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To compare respiratory-triggered T2-weighted fast spin-echo (RTT2W-FSE) and gradient T2*-weighted recalled-echo (T2*W-GRE) images for visualization of malignant hepatic tumors using ferucarbotran-enhanced magnetic resonance (MR) imaging. MATERIALS AND METHODS Ferucarbotran-enhanced RTT2W-FSE and breath-hold long-TE 2D-fast spoiled gradient recalled acquisition in the steady state (FSPGR) images as T2*W-GRE were used to evaluate 128 malignant hepatic tumors (77 metastases, 37 hepatocellular carcinomas, 14 other) in 62 patients. Tumor-to-liver contrast (TLC) was quantitatively compared using the paired Student's t-test, and the score of lesion conspicuity was qualitatively compared using Wilcoxon's signed rank test. RESULTS The mean TLC of RTT2W-FSE was significantly higher than that of FSPGR (1.10 +/- 0.82 vs. 2.54 +/- 1.42) in all malignant tumors. The score of lesion conspicuity of RTT2W-FSE was significantly higher than that of FSPGR (4.84 +/- 0.52 vs. 4.52 +/- 0.99) in all malignant tumors. CONCLUSION For ferucarbotran-enhanced MR imaging, compared to FSPGR images, RTT2W-FSE images provide greater TLC and subjective conspicuity for malignant tumors.
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Affiliation(s)
- Koichi Ishiyama
- Department of Radiology, Akita University School of Medicine, Akita, Japan.
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Kim YK, Kwak HS, Han YM, Kim CS. Usefulness of Combining Sequentially Acquired Gadobenate Dimeglumine-Enhanced Magnetic Resonance Imaging and Resovist-Enhanced Magnetic Resonance Imaging for the Detection of Hepatocellular Carcinoma. J Comput Assist Tomogr 2007; 31:702-11. [PMID: 17895780 DOI: 10.1097/rct.0b013e31802d0b6b] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To investigate the diagnostic efficacy of sequentially acquired gadobenete dimeglumine-enhanced 3-dimensional dynamic magnetic resonance imaging (MRI) and Resovist-enhanced MRI for detecting hepatocellular carcinoma (HCC) by comparing with combined computed tomography (CT) hepatic arteriography (CTHA) and CT arterioportography (CTAP) using 16-slice multidetector CT. MATERIALS Twenty-nine patients with 50 HCCs underwent sequentially acquired double-contrast MRI--gadobenate dimeglumine-enhanced dynamic MRI and Resovist-enhanced MRI--and combined CTHA and CTAP using 16-slice multidetector CT. Dynamic MRI was obtained using volumetric interpolated technique and sensitivity encoding on a 1.5-T unit. Resovist-enhanced MRI was composed of T2-weighted turbo spin-echo and T2*-weighted gradient echo sequences. Sensitivity, positive predictive value, and diagnostic accuracy for double-contrast MRI, gadolinium-enhanced MRI, and combined CTHA and CTAP were calculated by 2 observers using an alternative-free response receiver operating characteristic analysis. RESULTS For all observers, the Az values of double-contrast MRI (mean, 0.96) and combined CTHA and CTAP (mean, 0.93) were similar, which tended to be better than that of gadolinium-enhanced MRI (mean, 0.91). The sensitivity of double-contrast MRI (mean, 93%) and combined CTHA and CTAP (mean, 92%) was equivalent for all observers, which was better than that of gadolinium-enhanced MRI (mean, 85%; P < 0.05). The positive predictive value of double-contrast MRI was better than that of combined CTHA and CTAP (P < 0.05). CONCLUSION The sequentially acquired double-contrast MRI and combined CTHA and CTAP showed a similar diagnostic accuracy and sensitivity for detecting HCC.
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Affiliation(s)
- Young Kon Kim
- Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, South Korea.
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Glockner JF. Hepatobiliary MRI: current concepts and controversies. J Magn Reson Imaging 2007; 25:681-95. [PMID: 17352396 DOI: 10.1002/jmri.20844] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Evaluation of the liver and biliary system is a frequent indication for abdominal MRI. Hepatobiliary MRI comprises a set of noninvasive techniques that are usually very effective in answering most clinical questions. There are significant limitations, however, as well as considerable variation and disagreement regarding the optimal protocols for standard hepatic MRI and magnetic resonance cholangiopancreaticography (MRCP). This review discusses pulse sequences most often used in hepatic MRI and MRCP, examines a few sources of controversy in the current literature, and summarizes some recent and future developments in the field.
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Affiliation(s)
- James F Glockner
- Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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Gomi T, Nagamoto M, Tsunoo M, Terada S, Terada H, Kohda E. Evaluation of the changes in signals from the spleen using ferucarbotran. ACTA ACUST UNITED AC 2007; 25:135-8. [PMID: 17450339 DOI: 10.1007/s11604-006-0108-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Accepted: 11/27/2006] [Indexed: 01/18/2023]
Abstract
PURPOSE Because superparamagnetic iron oxide is actively taken into the reticuloendothelial system, the signal intensity observed on T2-weighted images is reduced not only in the liver but also in the spleen. There is no difference in the reduction in signal intensity in the liver after contrast between the ferumoxides and ferucarbotran, but the reduction in signal intensity in the spleen is considerable. In the present study, we examined the efficacy of T2*-weighted imaging to compensate for the reduction in signal intensity in the spleen by administering ferucarbotran. MATERIALS AND METHODS We examined the images obtained from 35 patients who underwent MRI with ferucarbotran. T2-weighted images and T2*-weighted images were obtained before and after administration of ferucarbotran, and the changes in signal intensity in the liver and spleen were then analyzed. RESULTS A reduction in signal intensity was observed in the liver by both T2- and T2*-weighted imaging. In the spleen, the signal intensity was reduced on T2-weighted images but was not reduced on T2*-weighted images. CONCLUSION The reduction in signal intensity due to administration of ferucarbotran is low in the spleen. Thus, it was considered necessary to approach the problem of diagnosing ectopic splenic tissue using ferucarbotran with caution.
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Affiliation(s)
- Tatsuya Gomi
- Department of Radiology, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.
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Kim MJ, Kim JH, Choi JY, Park SH, Chung JJ, Kim KW, Mitchell DG. Optimal TE for SPIO-enhanced gradient-recalled echo MRI for the detection of focal hepatic lesions. AJR Am J Roentgenol 2006; 187:W255-66. [PMID: 16928903 DOI: 10.2214/ajr.05.0706] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The objective of our study was to determine the optimal TE for superparamagnetic iron oxide (SPIO)-enhanced gradient-recalled echo (GRE) MRI for the detection of focal hepatic lesions. MATERIALS AND METHODS Ferucarbotran-enhanced GRE sequences, performed on a 1.5-T MR system, were used to evaluate 131 lesions (38 hepatocellular carcinomas, 37 metastases, 21 hemangiomas, 7 cholangiocarcinomas, 15 cysts, and 13 miscellaneous lesions) at four different TEs: 9, 13.5, 18, and 22.5 milliseconds. The lesion-to-liver signal difference-to-noise ratio (SDNR) was compared among the four GRE sequences by paired Student's t tests and among lesion types by an independent samples Student's t test. The McNemar test was used to compare the sensitivity for the detection of focal hepatic lesions. Wilcoxon's signed rank test was used to compare the subjective lesion conspicuity. RESULTS The SDNRs of lesions on GRE images obtained at a TE of 13.5 milliseconds (mean +/- SD, 60 +/- 24) were significantly (p < 0.001) higher than those at TEs of 9 (55 +/- 23), 18 (55 +/- 22), and 22.5 milliseconds (47 +/- 19). The SDNR was highest at a TE of 13.5 milliseconds for SPIO-uptake lesions and was comparable on images obtained with TEs of 18 and 13.5 milliseconds for non-SPIO-uptake lesions. The non-SPIO-uptake lesions showed a significantly higher SDNR than the SPIO-uptake lesions at a TE of 22.5 milliseconds (p = 0.007). The overall sensitivity for lesion detection was not significantly different among the four GRE sequences, and the subjective ratings of lesion conspicuity were comparable for images obtained using TEs of 8, 13.5, and 18 milliseconds, but the ratings of lesion conspicuity were significantly lower for images obtained using a TE of 22.5 milliseconds (p < 0.001). CONCLUSION For ferucarbotran-enhanced MRI, lesion SDNR was highest on images obtained using a TE of 13.5 milliseconds, but the sensitivity and lesion conspicuity were comparable at TEs of 9 and 18 milliseconds. The SDNR of liver lesions varied according to the lesion's potential capability of taking up SPIO agents.
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Affiliation(s)
- Myeong-Jin Kim
- Department of Diagnostic Radiology, Yonsei University College of Medicine, Seodaemun-ku Shinchon-dong 134, Seoul 120-752, Republic of Korea.
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Kim SH, Choi D, Lim HK, Kim MJ, Jang KM, Kim SH, Lee WJ, Lee J, Jeon YH, Lim JH. Detection of hepatic VX2 carcinomas with ferucarbotran-enhanced magnetic resonance imaging in rabbits: Comparison of nine pulse sequences. Eur J Radiol 2006; 59:413-23. [PMID: 16678373 DOI: 10.1016/j.ejrad.2006.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2005] [Revised: 03/07/2006] [Accepted: 03/15/2006] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the diagnostic performance of a variety of magnetic resonance imaging (MRI) sequences, in order to identify the most effective ferucarbotran-enhanced sequence for the detection of multiple small hepatic VX2 carcinomas in rabbits. METHODS Fifteen rabbits with experimentally induced 135 VX2 carcinomas in the liver underwent ferucarbotran-enhanced MRI using the following nine pulse sequences: a fat-suppressed fast spin-echo (FSE) sequence with two echo times (TE) (proton density- and T2-weighted images), four different T2*-weighted fast multiplanar GRASS (gradient-recalled acquisition in the steady state) (FMPGR) with the combination of three TEs (9, 12, 15 ms, respectively) and two flip angles (20 degrees , 80 degrees, respectively), T2*-weighted fast multiplanar spoiled GRASS (FMPSPGR), T1-weighted FMPSPGR, and dynamic T1-weighted FMPSPGR. All images were reviewed by three radiologists with quantitative and qualitative analysis. RESULTS Tumor-to-liver contrast-to-noise ratio of the proton density-weighted FSE sequence was significantly higher than those of the others (p<0.05). The lesion conspicuities of proton density- and T2-weighted FSE and T2*-weighted FMPGR (TE/flip angle, 9/20 degrees and 12/20 degrees ) images were better and the image artifacts of T2*-weighted FMPGR (TE/flip angle, 15/20 degrees and 12/80 degrees ) and T2*-weighted FMPSPGR images were more prominent than those of the others (p<0.05). The lesion detection in T2- and proton density-weighted FSE and T2*-weighted FMPGR (TE/flip angle, 12/20 degrees ) images were superior to those of the others and for the detection of very small hepatic tumors of less than 5 mm, the sensitivities of these sequences were less than 30%. CONCLUSION Ferucarbotran-enhanced T2- and proton density-weighted FSE and T2*-weighed FMPGR (TE/flip angle, 12/20 degrees ) images were found to be the most effective pulse sequences for the detection of multiple small hepatic VX2 carcinomas but these sequences were limited in the detection of very small hepatic tumors of less than 5 mm in size.
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Affiliation(s)
- Seong Hyun Kim
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, South Korea
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Kim HJ, Kim KW, Byun JH, Won HJ, Shin YM, Kim PN, Lee MS, Lee MG. Comparison of mangafodipir trisodium- and ferucarbotran-enhanced MRI for detection and characterization of hepatic metastases in colorectal cancer patients. AJR Am J Roentgenol 2006; 186:1059-66. [PMID: 16554579 DOI: 10.2214/ajr.04.1941] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The purpose of our study was to evaluate the validity of mangafodipir trisodium-enhanced versus ferucarbotran-enhanced MRI in the detection and characterization of hepatic lesions in colorectal cancer patients. MATERIALS AND METHODS Forty-one patients who were known to have or suspected of having hepatic metastasis from colorectal carcinoma underwent mangafodipir trisodium- or ferucarbotran-enhanced MRI in block randomization methods. Two radiologists independently reviewed the MR images to determine the number of hepatic lesions and to characterize the lesions as malignant or benign. Each lesion was assessed according to its size (small, <or= 2 cm; large, > 2 cm in diameter) on both mangafodipir trisodium- or ferucarbotran-enhanced MRI. The data were correlated with the reference diagnosis: histopathology and intraoperative sonography (n = 16); intraoperative sonography (n = 4); and imaging and clinical diagnosis with follow-up (> 3 months; n = 21). The detection rates and diagnostic accuracies of hepatic lesions on both sets of MR images were assessed using Fisher's exact test. RESULTS Eighty-two hepatic lesions (53 metastatic and 29 benign) were identified in 41 patients. No significant differences were seen between mangafodipir trisodium- and ferucarbotran-enhanced MRI for detecting all hepatic lesions (p = 0.183), small hepatic lesions (p = 0.299), all metastases (p = 0.695), and small metastases (p = 0.689). The diagnostic accuracies of mangafodipir trisodium- and ferucarbotran-enhanced MRI showed no significant differences in all hepatic lesions (p = 0.624) and small hepatic lesions (p = 0.641). CONCLUSION Mangafodipir trisodium- and ferucarbotran-enhanced MRI are similar in hepatic lesion detection and characterization in colorectal cancer patients.
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Affiliation(s)
- Hyoung Jung Kim
- Department of Radiology, University of Ulsan-Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, South Korea
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Nasu K, Kuroki Y, Nawano S, Kuroki S, Tsukamoto T, Yamamoto S, Motoori K, Ueda T. Hepatic Metastases: Diffusion-weighted Sensitivity-encoding versus SPIO-enhanced MR Imaging. Radiology 2006; 239:122-30. [PMID: 16493012 DOI: 10.1148/radiol.2383041384] [Citation(s) in RCA: 269] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To retrospectively compare accuracy of diffusion-weighted (DW) single-shot echo-planar imaging with sensitivity encoding (SENSE) with that of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging in the evaluation of hepatic metastases due to extrahepatic malignancies. MATERIALS AND METHODS Patients provided informed consent; ethics committee approval was not required. The data of 24 patients (16 men, eight women; age range, 41-68 years; mean age, 61.9 years) with 40 resected hepatic metastases were retrospectively reviewed. Before SPIO administration, DW SENSE imaging and T2-weighted fast spin-echo (SE) and T1-weighted dual-echo fast field-echo (FFE) MR imaging were performed. After SPIO administration, T2-weighted fast SE, T1-weighted dual-echo, and T2*-weighted FFE MR examinations were performed. Images were divided into two sets: The SPIO-enhanced MR image set consisted of pre- and postcontrast T2-weighted fast SE and dual-echo T1-weighted FFE images and postcontrast T2*-weighted FFE images. The DW SENSE image set included DW SENSE images and precontrast T2-weighted fast SE and dual-echo T1-weighted FFE images. Three radiologists individually interpreted these images and sorted the confidence levels for presence of hepatic metastasis in each section into five grades. Area under the receiver operating characteristic (ROC) curve (A(z)) was calculated for each image set. RESULTS Hepatic metastases showed higher signal intensity on DW SENSE images than on T2-weighted fast SE images. Conversely, signals from vessels and cysts were suppressed with DW SENSE imaging. ROC analysis showed higher A(z) values when the DW SENSE image set was interpreted (0.90) than when the SPIO-enhanced MR image set was interpreted (0.81). The sensitivity and specificity, respectively, of total cases were 0.66 and 0.90, for the SPIO-enhanced MR image set and 0.82 and 0.94 for the DW SENSE image set. During SPIO-enhanced MR image interpretation, lesions 1 cm in diameter or smaller showed significantly lower sensitivity than lesions larger than 1 cm in diameter. During both interpretation sessions, left lobe lesions showed significantly lower sensitivity than right lobe lesions. CONCLUSION Combined reading of DW SENSE images and T2-weighted fast SE and dual-echo T1-weighted FFE MR images showed higher accuracy in the detection of hepatic metastases than did reading of SPIO-enhanced MR images.
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Affiliation(s)
- Katsuhiro Nasu
- Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
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Iwazawa J, Nishida N, Yamamoto A, Nango M, Ninoi T, Murakami Y, Nakamura K, Inoue Y. Detection of Portal Perfusion Abnormalities. J Comput Assist Tomogr 2006; 30:165-72. [PMID: 16628027 DOI: 10.1097/00004728-200603000-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To estimate the accuracy, sensitivity, and specificity of 3 ferucarbotran-enhanced magnetic resonance (MR) imaging sequences prospectively for the detection of nontumoral portal perfusion abnormalities. METHODS Thirty-nine noncirrhotic patients with liver metastases underwent computed tomography during arterial portography (CTAP) and MR imaging comprising T1-weighted gradient recalled echo (GRE), T2-weighted fast spin echo (FSE), and T2*-weighted GRE sequences with and without ferucarbotran. Magnetic resonance images were reviewed by 4 blinded observers for rating based on the confidence scale. The accuracy, sensitivity, and specificity for each sequence were measured by receiver operating characteristic analysis. Contrast-to-noise ratio (CNR) and relative signal-to-noise ratio changes were statistically compared. RESULTS Thirty-nine nontumoral perfusion defects were observed in 22 patients by CTAP. Receiver operating characteristic analysis showed the accuracy was higher for T2*-weighted GRE (0.884) than for T1-weighted GRE (0.572) and T2-weighted FSE (0.597). T2*-weighted imaging achieved the highest sensitivity (81.4%) and the lowest specificity (86.6%). Postenhanced T2*-weighted imaging achieved the highest CNR (19.3 +/- 9.2). CONCLUSIONS T2*-weighted imaging was the most accurate and sensitive method for detecting portal perfusion abnormalities compared with T1- or T2-weighted imaging, whereas T1- or T2-weighted imaging is superior in specificity to T2*-weighted imaging during ferucarbotran-enhanced MR imaging.
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Affiliation(s)
- Jin Iwazawa
- Department of Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
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Kiryu S, Watanabe M, Kabasawa H, Akahane M, Aoki S, Ohtomo K. Evaluation of Super Paramagnetic Iron Oxide-Enhanced Diffusion-Weighted PROPELLER T2-Fast Spin Echo Magnetic Resonance Imaging. J Comput Assist Tomogr 2006; 30:197-200. [PMID: 16628031 DOI: 10.1097/00004728-200603000-00005] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the usefulness of super paramagnetic iron oxide-enhanced, diffusion-weighted, periodically rotated overlapping parallel lines with enhanced reconstruction (SPIO DWI PROPELLER) T2-fast spin echo (FSE) magnetic resonance imaging (MRI) for the detection of hepatic metastases. METHODS Fourteen patients were examined with SPIO-enhanced T2-FSE (SPIO FSE) imaging and SPIO DWI PROPELLER T2-FSE imaging. The b-value of the diffusion-sensitizing gradient was 10 s/mm so as to suppress the signal of the hepatic vessels. Hepatic resections were performed on all patients, and the number of lesions on MRI was compared between the 2 pulse sequences with references from pathologic reports. RESULTS Nearly all metastases 1 cm or larger, totalling 38 metastases, were detected with both pulse sequences. Among the 30 metastases less than 1 cm, more lesions were detected on SPIO DWI PROPELLER T2-FSE imaging than on SPIO FSE imaging (16 for SPIO FSE imaging and 24 for DWI PROPELLER T2-FSE imaging; P < 0.05, McNemar test). CONCLUSION Super paramagnetic iron oxide-enhanced DWI PROPELLER T2-FSE is useful for detecting small hepatic metastases.
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Affiliation(s)
- Shigeru Kiryu
- Department of Radiology, Graduate School and Faculty of Medicine, University of Tokyo, Tokyo, Japan.
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Kim YK, Ko SW, Hwang SB, Kim CS, Yu HC. Detection and characterization of liver metastases: 16-slice multidetector computed tomography versus superparamagnetic iron oxide-enhanced magnetic resonance imaging. Eur Radiol 2006; 16:1337-45. [PMID: 16453115 DOI: 10.1007/s00330-005-0140-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2005] [Revised: 11/17/2005] [Accepted: 12/16/2005] [Indexed: 12/24/2022]
Abstract
The aim of our study was to compare the diagnostic performance of 16--slice multidetector computed tomography with that of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging in the detection of small hepatic metastases and in the differentiation of hepatic metastases from cysts. Twenty-three patients with 55 liver metastases and 14 liver cysts underwent SPIO-enhanced MR imaging and multiphasic CT using 16-MDCT. Two observers independently analyzed each image, in random order. Sensitivity and diagnostic accuracy for lesion detection and differentiation as metastases or cysts for MDCT and SPIO-enhanced MR imaging were calculated using receiver operating characteristic analysis. For all observers, the Az values of SPIO-enhanced MR imaging for lesion detection and differentiation of liver metastases from cysts (mean 0.955, 0.999) were higher than those of MDCT (mean 0.925, 0.982), but not statistically significantly so (P > 0.05). Sensitivity of SPIO-enhanced MR imaging with regard to the detection of liver metastases (mean 94.5%) was significantly higher than that of MDCT (mean 80.0%) (P < 0.05). SPIO-enhanced MR imaging and 16-MDCT showed similar diagnostic accuracies for detection and differentiation of liver metastases from cysts, but sensitivity of SPIO-enhanced imaging in the detection of liver metastases was superior to that of 16-MDCT.
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Affiliation(s)
- Young Kon Kim
- Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Keum Am Dong, Jeon Ju, South Korea.
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Tanimoto A, Kuribayashi S. Application of superparamagnetic iron oxide to imaging of hepatocellular carcinoma. Eur J Radiol 2006; 58:200-16. [PMID: 16414230 DOI: 10.1016/j.ejrad.2005.11.040] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Revised: 11/25/2005] [Accepted: 11/29/2005] [Indexed: 11/24/2022]
Abstract
Superparamagnetic iron oxide (SPIO) particles are as MR contrast media composed of iron oxide crystals coated with dextran or carboxydextran. These particles are sequestered by phagocytic Kupffer cells in normal reticuloendothelial system (RES), but are not retained in tumor tissue. Consequently, there are significant differences in T2/T2* relaxation between normal RES tissue and tumors, which result in increased lesion conspicuity and detectability. The introduction of SPIO has been expected to substantially increase the detectability of hepatic metastases. For focal hepatocellular lesions, it has been documented that SPIO-enhanced MR imaging exhibits slightly better diagnostic performance than dynamic helical CT in the detection of hypervascular hepatocellular carcinoma (HCC). A combination of dynamic and static MR imaging technique using T1- and T2 imaging criteria appears to provide clinically more useful patterns of enhancement. SPIO-enhanced MR imaging also provides information useful for differential diagnosis, via enhancement of RES-containing tumors. With the exploitation of rapid T2*-sensitive sequences, SPIO-enhanced dynamic MR imaging may become comparable to gadolinium-enhanced dynamic MR imaging and dynamic studies with multidetector-row CT. SPIO-enhanced MR imaging plays an important role in therapeutic decision-making for patients with HCC.
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Affiliation(s)
- Akihiro Tanimoto
- Department of Diagnostic Radiology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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Kim YK, Kwak HS, Kim CS, Chung GH, Han YM, Lee JM. Hepatocellular carcinoma in patients with chronic liver disease: comparison of SPIO-enhanced MR imaging and 16-detector row CT. Radiology 2005; 238:531-41. [PMID: 16371577 DOI: 10.1148/radiol.2381042193] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To compare the sensitivity, positive predictive value, and diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging with those of 16-detector row computed tomography (CT) for the detection of hepatocellular carcinoma (HCC) in patients with hepatitis B-induced cirrhosis. MATERIALS AND METHODS Institutional Review Board approval was obtained for this study, and informed consent was obtained from all patients. A total of 44 patients (36 men, eight women; age range, 35-67 years) with 59 HCCs and mild liver cirrhosis (Child-Pugh score A or B) underwent multiphasic CT and SPIO-enhanced MR imaging. The diagnosis of HCC was established at surgical resection (n = 31) and percutaneous biopsy (n = 28). SPIO-enhanced MR imaging was composed of T2-weighted turbo spin-echo and T2*-weighted gradient-echo sequences. Multiphasic CT consisted of four phases (ie, early arterial, late arterial, portal venous, and equilibrium). Three observers independently analyzed each image in random order. Sensitivity, positive predictive value, and diagnostic accuracy were calculated by using the alternative free-response receiver operating characteristic analysis for multi-detector row CT and SPIO-enhanced MR imaging. RESULTS Although not significant (P > .05), the area under the receiver operating characteristic curve for SPIO-enhanced MR imaging (mean, 0.90) was higher than that for multi-detector row CT (mean, 0.82) for all observers. Also, although no significant difference was demonstrated by any of the three observers (P > .05), there was a trend toward increased sensitivity on both a per-lesion and a per-patient basis for SPIO-enhanced MR imaging (mean, 84.7% and 94.7%, respectively) compared with multi-detector row CT (mean, 76.9% and 88.6%, respectively). No significant difference in positive predictive value was observed between modalities. CONCLUSION SPIO-enhanced MR imaging and multiphasic CT show similar diagnostic accuracy, sensitivity, and positive predictive value for the detection of HCC in patients with relatively mild hepatitis B-induced cirrhosis.
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Affiliation(s)
- Young Kon Kim
- Department of Diagnostic Radiology, Chonbuk National University Medical School and Hospital, Jeonju, Korea
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Kim YK, Kim CS, Kwak HS, Lee JM. Three-dimensional dynamic liver MR imaging using sensitivity encoding for detection of hepatocellular carcinomas: comparison with superparamagnetic iron oxide-enhanced mr imaging. J Magn Reson Imaging 2005; 20:826-37. [PMID: 15503325 DOI: 10.1002/jmri.20188] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To assess the diagnostic performance of three-dimensional dynamic liver imaging with sensitivity encoding (SENSE), including double arterial phase images and increased resolution, by comparing it to superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging for the detection of hypervascular hepatocellular carcinoma (HCC). MATERIALS AND METHODS Twenty-seven consecutive patients with 50 HCCs underwent Gd-BOPTA-enhanced dynamic imaging using SENSE and SPIO-enhanced MR imaging with at least a 24-hour interval between examinations. Using a three-dimensional gradient-echo technique applying SENSE, dynamic imaging consisting of double arterial phase-, portal phase- and delayed phase-images, was obtained. Using T2-weighted turbo spin-echo and T2*-weighted fast imaging with steady-state precession sequence, SPIO-enhanced MR imaging was obtained. For qualitative analysis, the diagnostic accuracy of both MR examinations for detecting the 50 HCCs was evaluated using the alternative free-response receiver operating characteristic method. Sensitivity and positive predictive value were also evaluated. RESULTS The mean sensitivity and positive predictive value of three-dimensional dynamic imaging with SENSE were 91.3% and 89.2%, respectively, and those of SPIO-enhanced imaging were 77.3% and 92.6 %, respectively. There was a significant difference in sensitivity between the two images (P <0.05). The mean Az value of three-dimensional dynamic imaging with SENSE (0.97 +/- 0.01) was significantly higher than that of SPIO-enhanced imaging (0.90 +/- 0.02) (P=0.00). CONCLUSION Three-dimensional dynamic liver MR imaging using SENSE for acquiring double arterial phase images is more efficient than SPIO-enhanced MR imaging for detecting HCCs.
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Affiliation(s)
- Young Kon Kim
- Department of Diagnostic Radiology, Chonbuk National University Medical School and Hospital, Chonju, South Korea
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Kwak HS, Lee JM, Kim YK, Lee YH, Kim CS. Detection of hepatocellular carcinoma: comparison of ferumoxides-enhanced and gadolinium-enhanced dynamic three-dimensional volume interpolated breath-hold MR imaging. Eur Radiol 2004; 15:140-7. [PMID: 15449000 DOI: 10.1007/s00330-004-2508-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2004] [Revised: 08/22/2004] [Accepted: 08/24/2004] [Indexed: 01/16/2023]
Abstract
The purpose was to compare the diagnostic accuracy of ferumoxides-enhanced MR imaging and gadolinium-enhanced dynamic MR imaging using three-dimensional (3D) volume interpolated breath-hold examination (VIBE) for the detection of hepatocellular carcinoma (HCC). Forty-nine patients with 61 HCCs, who underwent ferumoxides-enhanced and gadolinium-enhanced dynamic MR imaging, were included prospectively in this study. Ferumoxides-enhanced MR imaging was performed 24 h after completion of the dynamic study using 3D-VIBE. Three radiologists independently interpreted the images. The diagnostic accuracy was evaluated using the receiver-operating characteristic method, and the sensitivity of each imaging technique was compared using McNemar's test. The mean diagnostic accuracy of dynamic MR imaging (Az=0.95) was higher than that of ferumoxides-enhanced MR imaging (Az=0.90), but failed to reach a statistical significance (P=0.057). The mean sensitivity of dynamic MR imaging (90.7%) was significantly superior to that of ferumoxides-enhanced MR imaging (80.9%, P=0.03). Furthermore, for lesions smaller than 15 mm, the mean sensitivity of dynamic MR imaging was significantly higher than that of ferumoxides-enhanced MR imaging (85.2% vs. 69.2%, P<0.05). Dynamic MR imaging showed a trend toward better diagnostic accuracy for than ferumoxides-enhanced MR imaging for the detection of HCCs.
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Affiliation(s)
- Hyo-Sung Kwak
- Department of Diagnostic Radiology, Chonbuk National University Medical School, Chon-ju, South Korea
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Grazioli L. Response. J Magn Reson Imaging 2004. [DOI: 10.1002/jmri.20034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Lee JM, Kim IH, Kwak HS, Youk JH, Han YM, Kim CS. Detection of small hypervascular hepatocellular carcinomas in cirrhotic patients: comparison of superparamagnetic iron oxide-enhanced MR imaging with dual-phase spiral CT. Korean J Radiol 2003; 4:1-8. [PMID: 12679628 PMCID: PMC2698053 DOI: 10.3348/kjr.2003.4.1.1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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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Affiliation(s)
- Jeong-Min Lee
- Department of Diagnostic Radiology, Seoul National University Hospital, Korea.
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Lee JM, Kim CS, Youk JH, Lee MS. Characterization of focal liver lesions with superparamagnetic iron oxide-enhanced MR imaging: value of distributional phase T1-weighted imaging. Korean J Radiol 2003; 4:9-18. [PMID: 12679629 PMCID: PMC2698062 DOI: 10.3348/kjr.2003.4.1.9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To determine the potential value of distributional-phase T1-weighted ferumoxides-enhanced magnetic resonance (MR) imaging for tissue characterization of focal liver lesions. MATERIALS AND METHODS Ferumoxides-enhanced MR imaging was performed using a 1.5-T system in 46 patients referred for evaluation of known or suspected hepatic malignancies. Seventy-three focal liver lesions (30 hepatocellular carcinomas (HCC), 12 metastases, 15 cysts, 13 hemangiomas, and three cholangiocarcinomas) were evaluated. MR imaging included T1-weighted double-echo gradient-echo (TR/TE: 150/4.2 and 2.1 msec), T2*-weighted gradient-echo (TR/TE: 180/12 msec), and T2-weighted turbo spin-echo MR imaging at 1.5 T before and after intravenous administration of ferumoxides (15 mmol/kg body weight). Postcontrast T1-weighted imaging was performed within eight minutes of infusion of the contrast medium (distributional phase). Both qualitative and quantitative analysis was performed. RESULTS During the distributional phase after infusion of ferumoxides, unique enhancement patterns of focal liver lesions were observed for hemangiomas, metastases, and hepatocellular carcinomas. On T1-weighted GRE images obtained during the distributional phase, hemangiomas showed a typical positive enhancement pattern of increased signal; metastases showed ring enhancement; and hepatocellar carcinomas showed slight enhancement. Quantitatively, the signal-to-noise ratio of hemangiomas was much higher than that of other tumors (p <.05) and was similar to that of intrahepatic vessels. This finding permitted more effective differentiation between hemangiomas and other malignant tumors. CONCLUSION T1-weighted double-echo FLASH images obtained soon after the infusion of ferumoxides, show characteristic enhancement patterns and improved the differentiation of focal liver lesions.
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Affiliation(s)
- Jeong Min Lee
- Department of Diagnostic Radiology, Seoul National University Hospital, Korea.
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