European Radiology

, 18:457

Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions

Authors

    • Institute of Diagnostic and Interventional RadiologyJohann Wolfgang Goethe-University
  • Alexander Huppertz
    • Imaging Science Institute, Charitè - Siemens
  • Josy Breuer
    • Gobal Clinical Development Diagnostics, Bayer Schering Pharma AG
  • Thomas Balzer
    • Gobal Clinical Development Diagnostics, Bayer Schering Pharma AG
  • Anthony Blakeborough
    • Department of RadiologyRoyal Hallamshire Hospital
  • Rick Carter
    • Bayer Health Care Ltd.
  • Lluis Castells Fusté
    • Liver Unit, Department of Internal MedicineHospital Vall d`Hebròn
  • Gertraud Heinz-Peer
    • Allg. Krankenhaus der Stadt WienUniversitätsklinik für Radiodiagnostik
  • Werner Judmaier
    • Department of Magnetic Resonance Imaging and SpectroscopyUniversity Hospital Innsbruck
  • Michael Laniado
    • Institute for Diagnostic RadiologyUniversitätsklinikum Carl Gustav Carus, Technische Universität Dresden
  • Riccardo M. Manfredi
    • Department of RadiologyPoliclinico, University of Verona
  • Didier G. Mathieu
    • Centre d’Imagerie
  • Dieter Müller
    • Department of RadiologyGeorg-August Universität
  • Koenraad Mortelè
    • Department of Radiology (L1)Brigham and Women’s Hospital
  • Peter Reimer
    • Department of RadiologyKlinikum Karlsruhe
  • Maximilian F. Reiser
    • Institute of Clinical RadiologyLudwig-Maximilians-University Munich - Klinikum Grosshadern
  • Philip J. Robinson
    • Department of Clinical RadiologySt James’s University Hospital
  • Kohkan Shamsi
    • Corporate Clinical OperationsBerlex Laboratories Inc.
  • Michael Strotzer
    • Department of Diagnostic RadiologyUniversity Hospital
  • Matthias Taupitz
    • Department of RadiologyUniversitätsklinikum Charitè, Med. Fakultät der Humboldt-Universität
  • Bernd Tombach
    • Institute of Clinical RadiologyWestfälische Wilhelms Universität Münster
  • Gianluca Valeri
    • Department of RadiologyUniversity of Ancona, Regional Hospital Torette, Via Conca, Torette
  • Bernhard E. van Beers
    • Department of RadiologyUniversité Catholique de Louvain, St-Luc University Hospital
  • Thomas J. Vogl
    • Institute of Diagnostic and Interventional RadiologyJohann Wolfgang Goethe-University
  • For the European EOB-study group
Hepatobiliary-Pancreas

DOI: 10.1007/s00330-007-0716-9

Cite this article as:
Hammerstingl, R., Huppertz, A., Breuer, J. et al. Eur Radiol (2008) 18: 457. doi:10.1007/s00330-007-0716-9

Abstract

A multicenter study has been employed to evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) using the new liver-specific contrast agent gadoxetic acid (Gd-EOB-DTPA, Primovist), as opposed to contrast-enhanced biphasic spiral computed tomography (CT), in the diagnosis of focal liver lesions, compared with a standard of reference (SOR). One hundred and sixty-nine patients with hepatic lesions eligible for surgery underwent Gd-EOB-DTPA-enhanced MRI as well as CT within 6 weeks. Pathologic evaluation of the liver specimen combined with intraoperative ultrasound established the SOR. Data sets were evaluated on-site (14 investigators) and off-site (three independent blinded readers). Gd-EOB-DTPA was well tolerated. Three hundred and two lesions were detected in 131 patients valid for analysis by SOR. The frequency of correctly detected lesions was significantly higher on Gd-EOB-DTPA-enhanced MRI compared with CT in the clinical evaluation [10.44%; 95% confidence interval (CI): 4.88, 16.0]. In the blinded reading there was a trend towards Gd-EOB-DTPA-enhanced MRI, not reaching statistical significance (2.14%; 95% CI: −4.32, 8.6). However, the highest rate of correctly detected lesions with a diameter below 1 cm was achieved by Gd-EOB-DTPA-enhanced MRI. Differential diagnosis was superior for Gd-EOB-DTPA-enhanced MRI (82.1%) versus CT (71.0%). A change in surgical therapy was documented in 19 of 131 patients (14.5%) post Gd-EOB-DTPA-enhanced MRI. Gd-EOB-DTPA-enhanced MRI was superior in the diagnosis and therapeutic management of focal liver lesions compared with CT.

Keywords

Magnetic resonance imaging Computed tomography Focal liver lesions Liver-specific Hepatobiliary Gadoxetic acid-enhanced MRI Therapeutic strategy

Copyright information

© Springer-Verlag 2007