Hepatic lesions: Detection with ferumoxide-enhanced T1-weighted MR imaging

PURPOSE: To compare the use of ferumoxide-enhanced T1-weighted gradient-echo (GRE) MR imaging with that of spiral computed tomography during arterial portography (CTAP) and T2-weighted Turbo spin-echo (SE) MR imaging in detection of lesions and of segmental involvement in patients with liver metastases. MATERIALS AND METHODS: Twenty-two candidates for metastasectomy of the liver underwent spiral CTAP, ferumoxide-enhanced GRE MR imaging, and T2-weighted Turbo SE MR imaging. A total of 176 liver segments were evaluated (57 with and 119 without metastases). The reference standard was laparoscopic sonographic findings. Diagnostic performance of the imaging modalities was assessed for lesion detection and determination of segmental involvement. RESULTS: The sensitivity for lesion detection with spiral CTAP, ferumoxide-enhanced MR imaging, and T2-weighted MR imaging was 0.96, 0.83, and 0.71, respectively; for segmental analysis, the sensitivity was 0.96, 0.84, and 0.75, respectively, and the specificity was 0.80, 0.99, and 0.92, respectively. All comparisons between sensitivities and specificities were statistically significant (P < .05). CONCLUSION: Ferumoxide-enhanced T1-weighted GRE MR imaging is superior to T2-weighted SE MR imaging for preoperative detection of lesions and segmental involvement in patients with liver metastases.