Detection and Characterization of Focal Hepatic Tumors: A Comparison of T2-Weighted MR Images Before and After the Administration of Gadoxectic Acid

Purpose: To evaluate if T2-weighted images (T2WI) after administration of gadoxetic acid have diagnostic capability comparable to precontrast T2WI in the detection and characterization of focal liver lesions. Materials and Methods: Eighty patients with 128 liver lesions (71 hepatocellular carcinomas, 35 metastases, and 22 hemangiomas) underwent gadoxetic acid-enhanced T1WI and precontrast and postcontrast turbo spin echo-short tau inversion recovery (TSE-STIR) and respiratory triggered (RT)-TSE. The sensitivity for malignancy with combining T2WIs and enhanced T1WIs was evaluated and percentage of signal intensity loss (PSIL) and lesion-liver contrast to noise ratio (CNR) were calculated for T2WIs. Lesion characterization with T2WIs as solid and nonsolid was evaluated using kappa statistics. Results: The PSIL was higher with TSE-STIR than with RT-TSE (P = 0.0001). The malignancy-liver CNRs on postcontrast T2WIs were higher than on precontrast T2WIs (P = 0.0001). Sensitivity for malignancy by combining postcontrast T2WIs and T1WIs (93.0% [hepatocellular carcinoma, HCC]; 97.1% [metastases]) was comparable to sensitivity of combining precontrast T2WIs and postcontrast T1WIs (91.6% [HCC]: 88.6% [metastases]). Kappa values for T2WIs indicated excellent agreement (k = 0.935). Conclusion: Gadoxetic acid-enhanced T2WIs showed a comparable diagnostic capability to precontrast T2WIs for the detection and characterization of hepatic tumors.