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Gadoxetic Acid (Gd-EOB-DTPA)-Enhanced MRI versus Gadobenate Dimeglumine (Gd-BOPTA)-Enhanced MRI for Preoperatively Detecting Hepatocellular Carcinoma: an Initial Experience

  • Park, Yul-Ri (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Seong-Hyun (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Seung-Hoon (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jeon, Yong-Hwan (Department of Radiology, Kangwon National University Hospital) ;
  • Lee, Jong-Mee (Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Kim, Min-Ju (Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Choi, Don-Gil (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Won-Jae (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Hee-Jung (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Koo, Ji-Hyun (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lim, Hyo-Keun (Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2010.01.08
  • Accepted : 2010.04.09
  • Published : 2010.08.01

Abstract

Objective: This study was designed to compare the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging (MRI) with gadobenate dimeglumine-enhanced MRI for preoperatively detecting hepatocellular carcinoma (HCC). Materials and Methods: Eighteen consecutive patients (17 men and one woman, age range: 31-73 years) with 22 HCCs underwent examinations with gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI on a 3.0-Tesla unit. The diagnosis of HCC was established after surgical resection and pathological conformation. Three observers independently reviewed each MR image in a random order on a tumor-by-tumor basis. The diagnostic accuracy of these techniques for the detection of HCC was assessed by performing an alternative free-response receiver operating characteristic (ROC) analysis. The sensitivity and positive predictive values were evaluated. Results: The average value of the area under the ROC curve (Az) for gadoxetic acid enhanced MRI (0.887) was not significantly different from the Az (0.899) for gadobenate dimeglumine-enhanced MRI (p > 0.05). The overall sensitivities of gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI were 80% and 83%, respectively, with no significant difference (p > 0.05). The differences of the positive predictive values for the two contrast agents for each observer were not statistically significant (p > 0.05). Conclusion: The diagnostic performance of gadoxetic acid-enhanced MRI and gadobenate dimeglumine-enhanced MRI for preoperatively detecting HCC is quite similar.

Keywords

References

  1. Schuhmann-Giampieri G, Schmitt-Willich H, Press WR, Negishi C, Weinmann HJ, Speck U. Preclinical evaluation of Gd-EOBDTPA as a contrast agent in MR imaging of the hepatobiliary system. Radiology 1992;183:59-64 https://doi.org/10.1148/radiology.183.1.1549695
  2. van Montfoort JE, Stieger B, Meijer DK, Weinmann HJ, Meier PJ, Fattinger KE. Hepatic uptake of the magnetic resonance imaging contrast agent gadoxetate by the organic anion transporting polypeptide Oatp 1. J Pharmacol Exp Ther 1999;290:153-157
  3. de Haen C, Gozzini L. Soluble-type hepatobiliary contrast agents for MR imaging. J Magn Reson Imaging 1993;3:179-186 https://doi.org/10.1002/jmri.1880030130
  4. Kirchin MA, Pirovano GP, Spinazzi A. Gadobenate dimeglumine (Gd-BOPTA). An overview. Invest Radiol 1998;33:798-809 https://doi.org/10.1097/00004424-199811000-00003
  5. Spinazzi A, Lorusso V, Pirovano G, Kirchin M. Safety, tolerance, biodistribution, and MR imaging enhancement of the liver with gadobenate dimeglumine: results of clinical pharmacologic and pilot imaging studies in nonpatient and patient volunteers. Acad Radiol 1999;6:282-291 https://doi.org/10.1016/S1076-6332(99)80451-6
  6. Schuhmann-Giampieri G. Liver contrast media for magnetic resonance imaging. Interrelations between pharmacokinetics and imaging. Invest Radiol 1993;28:753-761 https://doi.org/10.1097/00004424-199308000-00018
  7. Spinazzi A, Lorusso V, Pirovano G, Taroni P, Kirchin M, Davies A. Multihance clinical pharmacology: biodistribution and MR enhancement of the liver. Acad Radiol 1998;5:S86-S89 https://doi.org/10.1016/S1076-6332(98)80069-X
  8. Hamm B, Staks T, Muhler A, Bollow M, Taupitz M, Frenzel T, et al. Phase I clinical evaluation of Gd-EOB-DTPA as a hepatobiliary MR contrast agent: safety, pharmacokinetics, and MR imaging. Radiology 1995;195:785-792 https://doi.org/10.1148/radiology.195.3.7754011
  9. Reimer P, Schneider G, Schima W. Hepatobiliary contrast agents for contrast-enhanced MRI of the liver: properties, clinical development and applications. Eur Radiol 2004;14:559- 578 https://doi.org/10.1007/s00330-004-2236-1
  10. Hwang HS, Kim SH, Jeon TY, Choi D, Lee WJ, Lim HK. Hypointense hepatic lesions depicted on gadobenate dimeglumine- enhanced three-hour delayed hepatobiliary-phase MR imaging: differentiation between benignancy and malignancy. Korean J Radiol 2009;10:294-302 https://doi.org/10.3348/kjr.2009.10.3.294
  11. Kim YK, Kim CS, Chung GH, Han YM, Lee SY, Chon SB, et al. Comparison of gadobenate dimeglumine-enhanced dynamic MRI and 16-MDCT for the detection of hepatocellular carcinoma. AJR Am J Roentgenol 2006;186:149-157 https://doi.org/10.2214/AJR.04.1206
  12. Kim YK, Kim CS, Lee YH, Kwak HS, Lee JM. Comparison of superparamagnetic iron oxide-enhanced and gadobenate dimeglumine-enhanced dynamic MRI for detection of small hepatocellular carcinomas. AJR Am J Roentgenol 2004;182:1217-1223 https://doi.org/10.2214/ajr.182.5.1821217
  13. Kim SH, Kim SH, Lee J, Kim MJ, Jeon YH, Park Y, et al. Gadoxetic acid-enhanced MRI versus triple-phase MDCT for the preoperative detection of hepatocellular carcinoma. AJR Am J Roentgenol 2009;192:1675-1681 https://doi.org/10.2214/AJR.08.1262
  14. Baron RL, Oliver JH, 3rd, Dodd GD, 3rd, Nalesnik M, Holbert BL, Carr B. Hepatocellular carcinoma: evaluation with biphasic, contrast-enhanced, helical CT. Radiology 1996;199:505-511 https://doi.org/10.1148/radiology.199.2.8668803
  15. Bruix J, Sherman M; Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology 2005;42:1208-1236 https://doi.org/10.1002/hep.20933
  16. Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL Conference. European Association for the Study of the Liver. J Hepatol 2001;35:421-430 https://doi.org/10.1016/S0168-8278(01)00130-1
  17. Jang HJ, Lim JH, Lee SJ, Park CK, Park HS, Do YS. Hepatocellular carcinoma: are combined CT during arterial portography and CT hepatic arteriography in addition to triplephase helical CT all necessary for preoperative evaluation? Radiology 2000;215:373-380 https://doi.org/10.1148/radiology.215.2.r00ma30373
  18. Kang BK, Lim JH, Kim SH, Choi D, Lim HK, Lee WJ, et al. Preoperative depiction of hepatocellular carcinoma: ferumoxides- enhanced MR imaging versus triple-phase helical CT. Radiology 2003;226:79-85 https://doi.org/10.1148/radiol.2261011827
  19. Sherman M. Diagnosis of small hepatocellular carcinoma. Hepatology 2005;42:14-16 https://doi.org/10.1002/hep.20790
  20. Bolondi L, Gaiani S, Celli N, Golfieri R, Grigioni WF, Leoni S, et al. Characterization of small nodules in cirrhosis by assessment of vascularity: the problem of hypovascular hepatocellular carcinoma. Hepatology 2005;42:27-34
  21. Huppertz A, Haraida S, Kraus A, Zech CJ, Scheidler J, Breuer J, et al. Enhancement of focal liver lesions at gadoxetic acidenhanced MR imaging: correlation with histopathologic findings and spiral CT--initial observations. Radiology 2005;234:468- 478 https://doi.org/10.1148/radiol.2342040278
  22. Narita M, Hatano E, Arizono S, Miyagawa-Hayashino A, Isoda H, Kitamura K, et al. Expression of OATP1B3 determines uptake of Gd-EOB-DTPA in hepatocellular carcinoma. J Gastroenterol 2009;44:793-798 https://doi.org/10.1007/s00535-009-0056-4
  23. Hanley JA, McNeil BJ. A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 1983;148:839-843 https://doi.org/10.1148/radiology.148.3.6878708
  24. McNeil BJ, Hanley JA, Funkenstein HH, Wallman J. Paired receiver operating characteristic curves and the effect of history on radiographic interpretation. CT of the head as a case study. Radiology 1983;149:75-77 https://doi.org/10.1148/radiology.149.1.6611955
  25. Bennett BM. On comparisons of sensitivity, specificity and predictive value of a number of diagnostic procedures. Biometrics 1972;28:793-800 https://doi.org/10.2307/2528763
  26. Fleiss JL. The measurement of interrater agreement. In: Fleiss JL, ed. Statistical methods for the rates and proportions, 2nd ed. New York, NY: John Wiley & Sons, 1981:212-236
  27. Uematsu H, Takahashi M, Dougherty L, Hatabu H. High field body MR imaging: preliminary experiences. Clin Imaging 2004;28:159-162 https://doi.org/10.1016/S0899-7071(03)00151-7
  28. Ludeke KM, Roschmann P, Tischler R. Susceptibility artefacts in NMR imaging. Magn Reson Imaging 1985;3:329-343 https://doi.org/10.1016/0730-725X(85)90397-2
  29. Kurihara Y, Yakushiji YK, Tani I, Nakajima Y, Van Cauteren M. Coil sensitivity encoding in MR imaging: advantages and disadvantages in clinical practice. AJR Am J Roentgenol 2002;178:1087-1091 https://doi.org/10.2214/ajr.178.5.1781087
  30. Chang JM, Lee JM, Lee MW, Choi JY, Kim SH, Lee JY, et al. Superparamagnetic iron oxide-enhanced liver magnetic resonance imaging: comparison of 1.5 T and 3.0 T imaging for detection of focal malignant liver lesions. Invest Radiol 2006;41:168-174 https://doi.org/10.1097/01.rli.0000192417.33989.7a
  31. Sun HY, Lee JM, Shin CI, Lee DH, Moon SK, Kim KW, et al. Gadoxetic acid-enhanced magnetic resonance imaging for differentiating small hepatocellular carcinomas (< or = 2 cm in diameter) from arterial enhancing pseudolesions: special emphasis on hepatobiliary phase imaging. Invest Radiol 2010;45:96-103 https://doi.org/10.1097/RLI.0b013e3181c5faf7
  32. Kim JI, Lee JM, Choi JY, Kim YK, Kim SH, Lee JY, et al. The value of gadobenate dimeglumine-enhanced delayed phase MR imaging for characterization of hepatocellular nodules in the cirrhotic liver. Invest Radiol 2008;43:202-210 https://doi.org/10.1097/RLI.0b013e31815d6929
  33. Yoon SH, Lee JM, So YH, Hong SH, Kim SJ, Han JK, et al. Multiphasic MDCT enhancement pattern of hepatocellular carcinoma smaller than 3 cm in diameter: tumor size and cellular differentiation. AJR Am J Roentgenol 2009;193:W482- W489 https://doi.org/10.2214/AJR.08.1818

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