Comparison of biphasic spiral CT and MnDPDP-enhanced MRI to detect and classify liver lesions.

Introduction: To evaluate the efficacy of biphasic spiral CT and MnDPDP (Teslascan (TM), Nycomed Amersham) enhanced MR imaging to detect and classify liver lesions. Materials and Methods: 39 patients with known or suspected liver lesions were included into this study and examined with biphasic spiral CT and MnDPDP-enhanced MRI. 25 histological reports and 1 extreme increased serum AFP value could be obtained from 22 patients, therefore only these 26 proven lesions were included into this analysis. Results: From 39 patients CT revealed in 54% (14 lesions) and MRI in 54% correct (i.e., corresponding to the histology) diagnosis. Correct CT/wrong MRT diagnosis and vice versa was present in only 2 lesions each. Differentiating into benign versus malignant lesion was successful in 73 % for MRI and 77 % for CT. In 81 % MRI revealed the correct type of lesion (hepatocellular or non-hepatocellular) vs. 77 % with CT. Sensitivity/specificity for differentiation into benign/malignant lesions was 86 %/ 70 % (MRI) and 87 %/77 % (CT) and for differentiation of the lesions origin 100 %/80 % (MRI) and 80 %/75 % (CT), these differences were not significant. MnDPDP-enhanced MRI showed significantly more lesions than non-enhanced MRI. Conclusion: MnDPDP-enhanced MRI is better than CT in differentiating hepatocellular liver lesions from non-hepatocellular lesions. After contrast enhancement with MnDPDP significantly more lesions could be evaluated in MRI. MnDPDP improves, in combination with biphasic helical CT,the diagnosis of liver lesions.