Korean J Radiol.  2010 Aug;11(4):433-440. 10.3348/kjr.2010.11.4.433.

Gadoxetic Acid (Gd-EOB-DTPA)-Enhanced MRI versus Gadobenate Dimeglumine (Gd-BOPTA)-Enhanced MRI for Preoperatively Detecting Hepatocellular Carcinoma: an Initial Experience

• Park Y
• Kim SH
• Kim SH
• Jeon YH
• Lee J
• Kim MJ
• Choi D
• Lee WJ
• Kim H
• Koo JH
• Lim HK

• KMID: 984897
• DOI: http://doi.org/10.3348/kjr.2010.11.4.433

Abstract

OBJECTIVE
This study was designed to compare the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging (MRI) with gadobenate dimeglumine-enhanced MRI for preoperatively detecting hepatocellular carcinoma (HCC).
MATERIALS AND METHODS
Eighteen consecutive patients (17 men and one woman, age range: 31-73 years) with 22 HCCs underwent examinations with gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI on a 3.0-Tesla unit. The diagnosis of HCC was established after surgical resection and pathological conformation. Three observers independently reviewed each MR image in a random order on a tumor-by-tumor basis. The diagnostic accuracy of these techniques for the detection of HCC was assessed by performing an alternative free-response receiver operating characteristic (ROC) analysis. The sensitivity and positive predictive values were evaluated.
RESULTS
The average value of the area under the ROC curve (Az) for gadoxetic acid enhanced MRI (0.887) was not significantly different from the Az (0.899) for gadobenate dimeglumine-enhanced MRI (p > 0.05). The overall sensitivities of gadoxetic acid enhanced MRI and gadobenate dimeglumine-enhanced MRI were 80% and 83%, respectively, with no significant difference (p > 0.05). The differences of the positive predictive values for the two contrast agents for each observer were not statistically significant (p > 0.05).
CONCLUSION
The diagnostic performance of gadoxetic acid-enhanced MRI and gadobenate dimeglumine-enhanced MRI for preoperatively detecting HCC is quite similar.

Keyword

Hepatocellular carcinoma (HCC); Gadoxetic acid-enhanced MRI; Gadobenate dimeglumine-enhanced MRI

MeSH Terms

Adult
Aged
Carcinoma, Hepatocellular/*diagnosis
Female
Gadolinium DTPA/*diagnostic use
Humans
Image Interpretation, Computer-Assisted
Liver Neoplasms/*diagnosis
Magnetic Resonance Imaging/*methods
Male
Meglumine/*analogs & derivatives/diagnostic use
Middle Aged
Organometallic Compounds/*diagnostic use
Predictive Value of Tests
ROC Curve
Sensitivity and Specificity
Statistics, Nonparametric

Figure

• 

  Fig. 1 50-year-old man with 1.8 cm moderately differentiated hepatocellular carcinoma (arrows) in liver segment VI. A-C. Gadoxetic acid-enhanced transverse MR images show arterial enhancement (A), washout during equilibrium phase (B) and hypointensity during hepatobiliary phase (C). This lesion was detected by all of observers. Tumor-to-liver contrast-to-noise ratios were 15, -2.1 and -30.1 during arterial, equilibrium and hepatobiliary phases, respectively. D-F. Gadobenate dimeglumine-enhanced transverse MR images show arterial enhancement (D), no washout during equilibrium phase (E) and hypointensity during hepatobiliary phase (F). This lesion was detected by all of observers. Tumor-to-liver contrast-to-noise ratios were 36.7, 9.8 and -4.9, during arterial, equilibrium and hepatobiliary phases, respectively.

• 

  Fig. 2 47-year-old man with 0.6 cm moderate-differentiated hepatocellular carcinoma (arrows) in liver segment VI. A, B. Gadoxetic acid-enhanced transverse MR images show arterial enhancement (A), washout during equilibrium phase (not shown) and hypointensity during hepatobiliary phase (B). All of observers missed this lesion. C, D. Gadobenate dimeglumine-enhanced transverse MR images show arterial enhancement (C), washout during equilibrium phase (not shown) and hypointensity during hepatobiliary phase (D). All of observers missed this lesion.

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