Performance of Gd‐EOB‐DTPA and superparamagnetic iron oxide particles in the detection of primary liver cancer: A comparative study by alternative free‐response receiver operating characteristic analysis

Abstract

The performance of gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) and superparamagnetic iron oxide (SPIO) particles in detecting liver cancer was compared using alternative free-response receiver operating characteristic (AFROC) analysis, which allowed observers to indicate both the confidence level and the locations of all perceived abnormalities. Axial T1-weighted MR images (1.5 T) pre/post Gd-EOB-DTPA (25 mumol/kg) injection were obtained for 12 rats with chemically induced liver tumors (64 tumors). T2-weighted images (T2WI) were obtained pre/post SPIO (10 mumol/kg) injection for the same animal. Liver signal-to-noise ratio (SNR), tumor-liver contrast-to-noise ratio (CNR), and histopathologic sections corresponding to MR images were obtained. In AFROC, the location and the confidence level for each tumor were indicated independently on MR images by four radiologists. By plotting true-positive fraction and probability of false-positive per image, the area under the AFROC curve (A1) was estimated and statistically analyzed between each sequence. Either drug significantly improved tumor-liver CNR (P < .001) and tumor detection (diameter < or = 6 mm; P < .05). Gd-EOB-DTPA significantly (P < .05) improved the A1 in T1WI. There was no A1 difference between T2WI + SPIO and T1WI + Gd-EOB-DTPA. Gd-EOB-DTPA-enhanced T1WI showed the same performance as SPIO-enhanced T2WI in detecting liver tumors.

Diffusion- and T2-weighted MR Imaging of the Liver: Effect of Intravenous Administration of Gadoxetic Acid Disodium

“…The SIRs of the liver parenchyma, malignant tumors, and benign lesions were comparable between pre-and post-contrast T 2 One more malignant lesion was detected by pre-(46.7z, 85/182) than post-contrast T 2 WI (46.1z, 84/182), but detectability of malignant and benign lesions did not diŠer signiˆcantly between pre-and post-contrast T 2 WI (Figs. 1, 2).…”

“…Considering those previous results, however, most researchers concluded that DWI and T 2 WI after gadoxetic acid administration can be substituted for those before contrast. 2,[15][16][17] We applied 2 non-zero or high b-values (b＝500 and 1000 s/mm 2 ) to obtain ADC values. The choice of 2 high b-values over conventional b-values, e.g., b＝0 and 1000 s/mm 2 , has some advantage.…”

“…We measured the signal intensity ratio (SIR) of the liver parenchyma and focal hepatic lesion and the lesion-liver contrast intensity ratio (CIR) for both pre-and post-contrast DWI and T 2 WI using the following 3 formulae: SIR of liver parenchyma＝signal intensity of liver/signal intensity of skeletal muscle [1]. SIR of hepatic lesion＝ signal intensity of the hepatic lesion/signal intensity of skeletal muscle [2]. CIR＝(signal intensity of lesion-signal intensity of liver)/signal intensity of skeletal muscle [3].…”

“…[1][2][3][4][5] Uptake by hepatocytes of approximately half the injected dose of gadoxetic acid improves detection of liver malignancies on hepatocyte-phase imaging. [6][7][8] When gadoxetic acid is used, hepatocyte-phase imaging can be acquired 10 to 20 min after injection of the contrast material.…”

Diagnostic efficacy of gadoxetic acid-enhanced MRI in the detection of hepatocellular carcinomas: comparison with gadopentetate dimeglumine

“…Gadoxetic acid-enhanced MRI is a more sensitive diagnostic tool for detection of HCC than gadopentetate dimeglumine-enhanced MRI. Gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (gadoxetic acid disodium or Gd-EOB-DTPA) is a recently introduced liver-specific MR contrast agent that has the combined properties of an extracellular space contrast (ECS) agent and a liver-specific agent [1][2][3][4][5][6][7][8]. This combination of gadolinium chelates and superparamagnetic iron oxide particles is considered the most reliable, non-invasive diagnostic MR tool for evaluating hepatocellular carcinoma (HCC), so the dual properties of gadoxetic acid make it a good candidate for the early detection and accurate characterisation of HCC [9][10][11][12].…”