Abstract
Background: Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA; gadoxetic acid disodium, Primovist, Bayer Healthcare, Berlin, Germany) is a gadolinium based contrast agent with hepatocyte specific properties. In patients scanned for hepatic metastasis using Gd-EOB-DTPA, it is important to differentiate hepatic metastasis with cysts and hemangiomas, which are the two most common benign lesions seen in the liver. Yet, in some cases it is difficult to differentiate these lesions. Purpose: The purpose of this study was to retrospectively investigate the usefulness of combining Fluid-attenuated inversion recovery (FLAIR) with Gd-EOB-DTPA enhanced MRI. Material and Methods: Gd-EOB-DTPA enhanced MRIs of 47 patients (19 male, 27 female) with a mean age of 68 years (range 32 - 85 years old) with a total of 121 lesions (68 cysts, 37 metastasis, 16 hemangiomas) were included in the study. T1WI, T2WI, heavy T2WI, dynamic contrast enhanced MRI, and FLAIR images of these lesions were evaluated. The patients were randomly divided into two groups (Groups A and B), and two independent radiologists were asked to give a diagnosis for each lesion. The radiologists were allowed to view FLAIR images for only Group B. Diagnostic performance regarding the differentiation of cysts, hemangiomas and metastases was assessed. MRI examinations were scanned using a 1.5 Tesla system (Echlon Vega, Hitachi,) with an 8 channel multiple array coil (RAPID body coil). Results: An statistically significant improvement (p < 0.05) of the specificity for cysts was seen from 71.9% (Group A) to 90.9% (Group B) for Reader 1, and 75.0% (Group A) to 93.3% (Group B) for Reader 2. No statistical differences were seen between the two groups for sensitivity and specificity of hemangiomas. Although no statistical difference was seen between the two groups, an improvement (77.8 in Group A to 97.2 in Group B for Reader 1, and 85.7 in Group A to 100 in Group B for Reader 2) was seen for the sensitivity of metastasis with the addition of FLAIR. Conclusion: An improvement of diagnostic accuracy, especially for cysts, was seen with the addition of FLAIR to Gd-EOB-DTPA enhanced MRI.
Highlights
Hepatobiliary-specific contrast agents are a type of contrast agents used in magnetic resonance imaging (MRI)
Reader 1 correctly diagnosed 28/37 cysts in Group A, compared to 28/31 in Group B. 8 cysts were diagnosed as hemangiomas, and 1 cyst was diagnosed as a metastasis in Group A. 3 cysts were diagnosed as hemangiomas in Group B
Reader 2 correctly diagnosed 30/37 cysts in Group A, compared to 29/31 in Group B.6 cysts were diagnosed as hemangiomas and 1 cyst was diagnosed as a metastasis in Group A. 2 cysts were diagnosed as hemangiomas in Group B
Summary
Hepatobiliary-specific contrast agents are a type of contrast agents used in magnetic resonance imaging (MRI). Gd-EOB-DTPA enhanced magnetic resonance imaging (MRI) has become an important tool for the imaging of the liver, and has been reported to have a good sensitivity and specificity for the diagnosis of hepatic lesions [1] [2] [3] [4] [5]. In patients who are scanned for hepatic metastasis using Gd-EOB-DTPA, the differentiation of metastasis from cyst and hemangioma, the two most common benign lesions of the liver, is important. In patients scanned for hepatic metastasis using Gd-EOB-DTPA, it is important to differentiate hepatic metastasis with cysts and hemangiomas, which are the two most common benign lesions seen in the liver. Conclusion: An improvement of diagnostic accuracy, especially for cysts, was seen with the addition of FLAIR to GdEOB-DTPA enhanced MRI
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
