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Diffusion-weighted MR imaging before and after contrast enhancement with superparamagnetic iron oxide for assessment of hepatic metastasis

 Hana Kim  ;  Jeong-Sik Yu  ;  Dae Jung Kim  ;  Jae-Joon Chung  ;  Joo Hee Kim  ;  Ki Whang Kim 
 YONSEI MEDICAL JOURNAL, Vol.53(4) : 825-833, 2012 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Contrast Media*/chemistry ; Diffusion Magnetic Resonance Imaging/methods* ; Female ; Ferric Compounds*/chemistry ; Humans ; Liver Neoplasms/diagnosis* ; Male ; Neoplasm Metastasis/diagnosis*
Liver ; metastasis ; diffusion magnetic resonance imaging ; superparamagnetic iron oxide (SPIO)
PURPOSE: The purpose of our study was to validate diffusion-weighted MRI (DWI) before and after superparamagnetic iron oxide (SPIO) injection for assessment of hepatic metastases. MATERIALS AND METHODS: Eighty-six hepatic metastases (size range, 0.3-4.7 cm; mean, 1.5 cm) verified pathologically or by follow-up imaging studies in 22 consecutive patients (17 men and 5 women; 44-83 years; mean age, 60 years) during a 13-month period were enrolled. Hepatic MRI, including DWI (b-factors=50, 400, 800 s/mm²) with breath-holding technique of single-shot spin-echo echo-planar imaging (TR/TE=1000/69 ms, average=2) before and after SPIO administration, were retrospectively reviewed by two independent radiologists with a 5-point scale confidence score for each hepatic lesion on pre-contrast DWI (pre-DWI), SPIO-enhanced DWI (SPIO-DWI), and SPIO-enhanced T2*-weighted imaging (SPIO-T2*wI). RESULTS: For all lesions, SPIO-T2*wI showed significantly higher confidence score in the diagnosis of hepatic metastases than pre-contrast or SPIO-DWI regardless of the size of b-factors (p<0.05) with only one exception; using b-factor=50 s/mm², the score of SPIO-T2*wI was still higher than SPIO-DWI but there was no statistical significance given by observer 1 (p=0.730). For the subcentimeter lesions (n=37), SPIO-T2*wI showed the highest score, and using b-factor= 50 or 400 s/mm² SPIO-DWI showed similar confidence scores to SPIO-T2*wI by both observers (p>0.05). Pre-DWI using b-factor=50 sec/mm² was also comparable with SPIO-T2*wI by observer 1 (p=0.060). CONCLUSION: Pre-DWI has a limited value for the assessment of hepatic metastases, however, the repetition of DWI after SPIO injection using small b-factors could complement SPIO-T2*wI, especially for subcentimeter lesions.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Kim, Ha Na(김하나)
Yu, Jeong Sik(유정식) ORCID logo https://orcid.org/0000-0002-8171-5838
Chung, Jae Joon(정재준) ORCID logo https://orcid.org/0000-0002-7447-1193
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