MRI for detection of hepatocellular carcinoma: Comparison of mangafodipir trisodium and gadopentetate dimeglumine contrast agents

OBJECTIVE. The purpose of our study was to compare the performance of mangafodipir trisodium (Mn-DPDP)-enhanced and dynamic gadopentetate dimeglumine-enhanced MRI for the detection of hepatocellular carcinoma. MATERIALS AND METHODS. Forty-six patients with 96 hepatocellular carcinomas underwent Mn-DPDP- and gadopentetate dimeglumine-enhanced MRI. The MRI examination included unenhanced T2-weighted turbo spin-echo and T1-weighted 2D fast low-angle shot (FLASH) sequences and a 3D FLASH sequence after the administration of gadopentetate dimeglumine and Mn-DPDP. Two observers reviewed three sets of images: a set of gadopentetate dimeglumine-enhanced MR images, a set of Mn-DPDP-enhanced MR images, and a combination of the gadopentetate dimeglumine and Mn-DPDP sets. Using receiver operating characteristic (ROC) analysis, imaging sets were compared for diagnostic accuracy and sensitivity. RESULTS. The area under the ROC curve (A(z)) was 0.942 for the gadopentetate dimeglunrine-Mn-DPDP set, 0.932 for the gadopentetate dimeglumine set, and 0.877 for the Mn-DPDP set (p < 0.05). The mean sensitivity was greater for the gadopentetate dimeglumine set than for the Mn-DPDP set (87.5% vs 72.4%; p < 0.05). The false-negative rate of the Mn-DPDP set was statistically greater than that of the gadopentetate dimeglumine set (27.6% vs 12.5%). Most false-negative cases in the Mn-DPDP set were due to small (diameter < 2 cm), isoenhanced lesions. CONCLUSION. Gadopentetate dimeglumine-enhanced MRI was superior to Mn-DPDP-enhanced MRI for the detection of hepatocellular carcinomas.