SPIO-Enhanced MRI Findings of Well-Differentiated Hepatocellular Carcinomas: Correlation with MDCT Findings

Abstract

ObjectiveThis study was designed to assess superparamagnetic iron oxide (SPIO)-enhanced MRI findings of well-differentiated hepatocellular carcinomas (HCCs) correlated with their multidetector-row CT (MDCT) findings.Materials and MethodsSeventy-two patients with 84 pathologically proven well-differentiated HCCs underwent triple-phase MDCT and SPIO-enhanced MRI at a magnetic field strength of 1.5 Tesla (n = 49) and 3.0 Tesla (n = 23). Two radiologists in consensus retrospectively reviewed the CT and MR images for attenuation value and the signal intensity of each tumor. The proportion of hyperintense HCCs as depicted on SPIO-enhanced T2- or T2*-weighted images were compared in terms of tumor size (< 1 cm and > 1 cm), five CT attenuation patterns based on arterial and equilibrium phases and magnetic field strength, by the use of univariate and multivariate analyses.ResultsSeventy-eight (93%) and 71 (85%) HCCs were identified by CT and on SPIO-enhanced T2- and T2*-weighted images, respectively. For the CT attenuation pattern, one (14%) of seven isodense-isodense, four (67%) of six hypodense-hypodense, four (80%) of five isodense-hypodense, 14 (88%) of 16 hyperdense-isodense and 48 (96%) of 50 hyperdense-hypodense HCCs were hyperintense (Cochran-Armitage test for trend, p < 0.001). Based on the use of multivariate analysis, the CT attenuation pattern was the only factor that affected the proportion of hyperintense HCCs as depicted on SPIO-enhanced T2- or T2*-weighted images (p < 0.001). Tumor size or magnetic field strength was not a factor that affected the proportion of hyperintense HCCs based on the use of univariate and multivariate analysis (p > 0.05).ConclusionMost well-differentiated HCCs show hyperintensity on SPIO-enhanced MRI, although the lesions show various CT attenuation patterns. The CT attenuation pattern is the main factor that affects the proportion of hyperintense well-differentiated HCCs as depicted on SPIO-enhanced MRI.

Labeling of cynomolgus monkey bone marrow-derived mesenchymal stem cells for cell tracking by multimodality imaging

“…All MRI experiments were performed with a Magnetom Vision 1.5 T (Siemens, Germany). Typical imaging parameters for in vivo imaging of cerebral anatomy used a multiple spin-echo sequence and T2 weighted sequences, which have been previously used for detection of SPIO-labeled cells [6,12,19], to assess MRI sensitivity of MIRB-labeled cMSCs.…”

How to Differentiate Borderline Hepatic Nodules in Hepatocarcinogenesis: Emphasis on Imaging Diagnosis

“…It is reported that about 40% of HCCs lack the arterial-phase hyperenhancement, which includes most early HCCs (Fig. 3) [57,58]. This can lead to a misdiagnosis, using extracellular contrast agents, of nondefinitive HCC.…”

Superparamagnetic iron oxide‐enhanced magnetic resonance imaging is useful in predicting malignant potential of vascular transformation of hypointense hypovascular nodules on gadoxetic acid‐enhanced magnetic resonance imaging

“…In our study, hyperintensity was observed in 12 nodules (16%) on SPIO‐enhanced T2‐weighted MRI. In several previous studies, 15–85% of well‐differentiated HCCs were hyperintense, as observed on SPIO‐enhanced T2‐weighted MRI . Most hypovascular nodules showing hypointensity during the HBP on Gd–EOB–DTPA‐enhanced MRI are regarded as well‐differentiated HCCs.…”

“…Superparamagnetic iron oxide (SPIO) is a liver‐specific contrast agent that is taken up by Kupffer cells and is a clinically useful method in the diagnosis of HCC . Malignant tumors generally lack Kupffer cells and appear to be hyperintense against the hypointense background of the surrounding normal hepatic parenchyma . The use of SPIO for detecting well‐differentiated HCCs is limited owing to the retained Kupffer cell activity within the tumor, although 15–85% of well‐differentiated HCCs have been reported to be hyperintense, as evidenced by SPIO‐enhanced T2‐ and T2 * ‐weighted MRI .…”