Percentage of signal intensity loss for characterisation of focal liver lesions in patients with chronic liver disease using ferucarbotran-enhanced MRI

Abstract

ABSTRACT. The purpose of this study was to determine the percentage of signal intensity loss (PSIL) threshold for the characterisation of focal liver lesions among patients with chronic liver disease. 55 nodules in 49 patients with chronic liver disease who underwent ferucarbotran-enhanced MR studies were included. Among the 49 patients, 40 had liver cirrhosis and 9 had chronic hepatitis. 8 haemangiomas, 3 focal nodular hyperplasia, 9 dysplastic nodules and 12 well, 19 moderately and 4 poorly differentiated hepatocellular carcinomas (HCCs) were revealed. The PSIL, signal-to-noise ratio and contrast-to-noise ratio of each lesion type were calculated. The diagnostic performance of PSIL on ferucarbotran-enhanced T 2 weighted images (PSIL T2WI ) and T 2 weighted fat-suppression images (PSIL FS-T2WI ) that characterised hepatic tumours was compared with receiver operating characteristic (ROC) analysis. Using ROC analysis, the diagnostic performance of PSIL FS-T2WI was superior to that of PSIL T2WI (p50.01). The mean PSIL FS-T2WI of the benign lesions was significantly higher than that of HCC (p,0.001), and the mean PSIL FS-T2WI of well-differentiated HCC was significantly higher than that of moderately/poorly differentiated HCCs (p50.001). With a PSIL FS-T2WI threshold of 40% in lesions characterising ferucarbotran-enhanced FS-T2WI, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 88.6%, 95%, 90.9%, 96.9% and 82.6%, respectively. In conclusion, with ferucarbotran-enhanced FS-T2WI, a PSIL FS-T2WI threshold of 40% for characterising focal liver nodules among patients with chronic liver disease is recommended. It is useful for distinguishing HCC from benign nodules.

A perspective on a rapid and radiation-free tracer imaging modality, magnetic particle imaging, with promise for clinical translation

“…The choice of SPIO and surface coating influence the potential diagnostic applications using MPI. A blood pool agent is useful in studying vascular defects, 6 whereas particles coated with carboxydextran are useful for imaging the liver 34 due to RES targeting or for labeling cells for long-term tracking. 5,35 Current SPIOs that are available for clinical use are Reso-vist™ (Japan for MRI), Nanotherm™ (Germany for Magnetic Hyperthermia), Feraheme™ (North America, for iron supplement therapy in anemic patients) and Sienna+ (Europe, for lymph node localization).…”

For Better or Worse, Iron Overload by Superparamagnetic Iron Oxide Nanoparticles as a MRI Contrast Agent for Chronic Liver Diseases

“…In addition, there were also differences in the enhancement by Resovist between NAFLD and chronic hepatitis C patients. In the HCC patients with liver cirrhosis, Chou et al reported that the T2-weighted fat suppression MRI with Resovist could well differentiate the chronic liver diseases such as hemangioma, dysplastic nodules, and focal nodular hyperplasia from HCC tumors due to a partial uptake of SPIONs by Kupffer cells (Table , entry 2) . Resovist was also effective to distinguish between fatty liver tissues and cirrhosis in the nondiffuse fatty infiltrated patients with a much lower uptake of SPIONs by Kupffer cells in cirrhosis (Table , entry 3) .…”

“…In the HCC patients with liver cirrhosis, Chou et al reported that the T2-weighted fat suppression MRI with Resovist could well differentiate the chronic liver diseases such as hemangioma, dysplastic nodules, and focal nodular hyperplasia from HCC tumors due to a partial uptake of SPIONs by Kupffer cells (Table 1, entry 2). 19 Resovist was also effective to distinguish between fatty liver tissues and cirrhosis in the nondiffuse fatty infiltrated patients with a much lower uptake of SPIONs by Kupffer cells in cirrhosis (Table 1, entry 3). 20 With the technique of dynamic susceptibility contrast MRI, liver perfusion using Resovist revealed that there was a much slower hepatic blood flow in the cirrhosis liver than that in the healthy one, which could be potentially used in the diagnosis of cirrhosis patients (Table 1, entry 4).…”