European Radiology

, 16:1337 | Cite as

Detection and characterization of liver metastases: 16--slice multidetector computed tomography versus superparamagnetic iron oxide-enhanced magnetic resonance imaging

  • Young Kon KimEmail author
  • Seog Wan Ko
  • Seung Bae Hwang
  • Chong Soo Kim
  • Hee Chul Yu


The aim of our study was to compare the diagnostic performance of 16--slice multidetector computed tomography with that of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging in the detection of small hepatic metastases and in the differentiation of hepatic metastases from cysts. Twenty-three patients with 55 liver metastases and 14 liver cysts underwent SPIO-enhanced MR imaging and multiphasic CT using 16-MDCT. Two observers independently analyzed each image, in random order. Sensitivity and diagnostic accuracy for lesion detection and differentiation as metastases or cysts for MDCT and SPIO-enhanced MR imaging were calculated using receiver operating characteristic analysis. For all observers, the Az values of SPIO-enhanced MR imaging for lesion detection and differentiation of liver metastases from cysts (mean 0.955, 0.999) were higher than those of MDCT (mean 0.925, 0.982), but not statistically significantly so (P>0.05). Sensitivity of SPIO-enhanced MR imaging with regard to the detection of liver metastases (mean 94.5%) was significantly higher than that of MDCT (mean 80.0%) (P<0.05). SPIO-enhanced MR imaging and 16-MDCT showed similar diagnostic accuracies for detection and differentiation of liver metastases from cysts, but sensitivity of SPIO-enhanced imaging in the detection of liver metastases was superior to that of 16-MDCT.


Liver neoplasms Computed tomography (CT) Technology Magnetic resonance (MR) Contrast media 


  1. 1.
    Hagspiel KD, Neidel KFW, Eichenberger AC, Weder W, Marincek B (1995) Detection of liver metastases: comparison of superparamagnetic iron-oxide-enhanced MR imaging at 1.5 T with dynamic CT, intraoperative US, and percutaneous US. Radiology 196:471–478PubMedGoogle Scholar
  2. 2.
    Ward J, Naik KS, Guthrie JA, Wilson D, Robinson PJ (1999) Hepatic lesion detection: comparison of MR imaging after the administration of superparamagnetic iron oxide with dual-phase CT by using alternative free response receiver operating characteristic analysis. Radiology 210:459–466PubMedGoogle Scholar
  3. 3.
    Semelka RC, Brown ED, Ascher SM, Patt RH, Bagley AS, Li W, Edelman RR, Shoenut JP, Brown JJ (1994) Solitary hepatic metastasis: comparison of dynamic contrast-enhanced CT and MR imaging with fat-suppressed T2-weighted, breath-hold T1-weighted FLASH, and dynamic gadolinium-enhanced FLASH sequences. J Magn Reson Imaging 4:319–323PubMedCrossRefGoogle Scholar
  4. 4.
    Bartolozzi C, Donati F, Cioni D, Procacci C, Morana G, Chiesa A, Grazioli L, Cittadini G, Cittadini G, Giovagnoni A, Gandini G, Maass J, Lencioni R (2004) Detection of colorectal liver metastases: a prospective multicenter trial comparing unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT. Eur Radiol 14:14–20CrossRefPubMedGoogle Scholar
  5. 5.
    Kim KW, Kim AY, Kim TK, Park SH, Kim HJ, Lee YK, Park MS, Ha HK, Kim PN, Kim JC, Lee MG (2004) Small (≤ 2 cm) hepatic lesions in colorectal cancer patients: detection and characterization on mangafodipir trisodium-enhanced MRI. AJR Am J Roentgenol 182:1233–1240PubMedGoogle Scholar
  6. 6.
    Torres CG, Lundby B, Sterud AT, McGill S, Gordon PB, Bjerknes HS (1997) MnDPDP for MR imaging of the liver: results from the European phase III studies. Acta Radiol 38:631–637PubMedCrossRefGoogle Scholar
  7. 7.
    Jones EC, Chezmar JL, Nelson RC, Bernardino ME (1992) The frequency and significance of small hepatic lesions (<15 mm) detected by CT. AJR Am J Roentgenol 158:535–539PubMedGoogle Scholar
  8. 8.
    Haider MA, Amitai MM, Rappaport DC, O’Malley ME, Hanbidge AE, Redston M, Lockwood GA, Gallinger S (2002) Multi-detector row helical CT in preoperative assessment of small (≤ 1.5 cm) liver metastases: is thinner collimation better? Radiology 225:137–142PubMedCrossRefGoogle Scholar
  9. 9.
    Krakora GA, Coakley FV, Williams G, Yeh BM, Breiman RS, Qayyum A (2004) Small hypoattenuating hepatic lesions at contrast-enhanced CT: prognostic importance in patients with breast cancer. Radiology 233:667–673PubMedCrossRefGoogle Scholar
  10. 10.
    Tsushima K, Nishie A, Yoshimitsu K, Taketomi A, Honda H (2005) Liver metastasis with apparent intratumoral superparamagnetic iron oxide uptake. Eur Radiol 15:2203–2204CrossRefPubMedGoogle Scholar
  11. 11.
    Takahama K, Amano Y, Hayashi H, Ishihara M, Kumazaki T (2003) Detection and characterization of focal liver lesions using superparamagnetic iron oxide-enhanced magnetic resonance imaging: comparison between ferumoxides-enhanced T1-weighted imaging and delayed-phase gadolinium-enhanced T1-weighted imaging. Abdom Imaging 28:525–530CrossRefPubMedGoogle Scholar
  12. 12.
    Reimer P, Jahnke N, Fiebich M, Schima W, Deckers F, Marx C, Holzknecht N, Saini S (2000) Hepatic lesion detection and characterization: value of nonenhanced MR imaging, superparamagnetic iron oxide-enhanced MR imaging, and spiral CT-ROC analysis. Radiology 217:152–158PubMedGoogle Scholar
  13. 13.
    Kim YK, Lee JM, Kim CS, Lee YH (2004) Gadobenate dimeglumine-enhanced liver MR imaging: value of delayed imaging for the characterization and detection of focal liver lesions. Eur Radiol 14:5–13CrossRefPubMedGoogle Scholar
  14. 14.
    Kim YK, Lee JM, Kim CS, Chung GH, Kim CY, Kim IH (2005) Detection of liver metastases: gadobenate dimeglumine-enhanced three-dimensional dynamic phases and one-hour delayed phase MR imaging versus superparamagnetic iron oxide-enhanced MR imaging. Eur Radiol 15:220–228CrossRefPubMedGoogle Scholar
  15. 15.
    Hu H, He HD, Foley WD, Fox SH (2000) Four multidetector-row helical CT: image quality and volume coverage speed. Radiology 215:55–62PubMedGoogle Scholar
  16. 16.
    Berland LL, Smith JK (1998) Multidetector-array CT: once again, technology creates new opportunities. Radiology 209:327–329PubMedGoogle Scholar
  17. 17.
    Murakami T, Kim T, Takamura M, Hori M, Takahashi S, Federle MP, Tsuda K, Osuga K, Nakamura H, Kudo M (2001) Hypervascular hepatocellular carcinoma: detection with double arterial phase multi-detector row helical CT. Radiology 218:763–767PubMedGoogle Scholar
  18. 18.
    Foley WD, Mallisee TA, Hohenwalter MD, Wilson CR, Quiroz FA, Taylor AJ (2000) Multiphase hepatic CT with a multirow detector CT scanner. AJR Am J Roentgenol 175:679–685PubMedGoogle Scholar
  19. 19.
    Wong K, Paulson EK, Nelson RC (2001) Breath-hold three-dimensional CT of the liver with multidetector helical CT. Radiology 219:75–79PubMedGoogle Scholar
  20. 20.
    National Comprehensive Cancer Network. Practice guidelines in oncology—v.1 (2005) Invasive breast cancer/clinical staging. Available at http://www.nccn. org/. Accessed 27 February 2005
  21. 21.
    Chakraborty DP, Winter LH (1990) Free-response methodology: alternate analysis and a new observer-performance experiment. Radiology 74:873–881Google Scholar
  22. 22.
    Metz CE (1986) ROC methodology in radiologic imaging. Invest Radiol 21:720–733PubMedCrossRefGoogle Scholar
  23. 23.
    Rao JN, Scott AJ (1992) A simple method for the analysis of clustered binary data. Biometrics 48:577–585PubMedCrossRefGoogle Scholar
  24. 24.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174PubMedCrossRefGoogle Scholar
  25. 25.
    Bipat S, van Leeuwen MS, Comans EFI, Piji ME, Bossuyt PM, Zwinderman AH, Stoker J (2005) Colorectal liver metastases: CT, MR imaging, and PET for diagnosis-meta-analysis. Radiology 237:123–131PubMedCrossRefGoogle Scholar
  26. 26.
    Kim MJ, Kim JH, Lim JS, Oh YT, Chung JJ, Choi JS, Lee WJ, Kim KW (2004) Detection and characterization of focal hepatic lesions: mangafodipir vs. superparamagnetic iron oxide-enhanced magnetic resonance imaging. J Magn Reson Imaging 20:612–621CrossRefPubMedGoogle Scholar
  27. 27.
    Ward J, Robinson PJ, Guthrie JA, Downing S, Wilson D, Lodge JP, Prasad KR, Toogood GJ, Wyatt JI (2005) Liver metastases in candidates for hepatic resection: comparison of helical CT and gadolinium- and SPIO-enhanced MR imaging. Radiology 237:170–180PubMedCrossRefGoogle Scholar
  28. 28.
    Fretz CJ, Elizondo G, Weissleder R, Hahn PF, Stark DD, Ferrucci JT Jr (1989) Superparamagnetic iron oxide-enhanced MR imaging: pulse sequence optimization for detection of liver cancer. Radiology 172:393–397PubMedGoogle Scholar
  29. 29.
    Kim SH, Choi D, Lim JH, Lee WJ, Jang HJ, Lim HK, Lee SJ, Cho JM, Kim SK, Kim GC (2002) Optimal pulse sequence for ferumoxides-enhanced MR imaging used in the detection of hepatocellular carcinoma: a comparative study using seven pulse sequences. Korean J Radiol 3:87–97PubMedCrossRefGoogle Scholar
  30. 30.
    Abdelmoumene A, Chevallier P, Chalaron M, Schneider F, Verdun FR, Frascarolo P, Meuli R, Schnyder P, Denys A (2005) Detection of liver metastases under 2 cm: comparison of different acquisition protocols in four row multidetector-CT (MDCT). Eur Radiol 15:1881–1887CrossRefPubMedGoogle Scholar
  31. 31.
    Furuta A, Ito K, Fujita T, Koike S, Shimizu A, Matsunaga N (2004) Hepatic enhancement in multiphasic contrast-enhanced MDCT: comparison of high- and low-iodine-concentration contrast medium in same patients with chronic liver disease. AJR Am J Roentgenol 183:157–162PubMedGoogle Scholar
  32. 32.
    Yagyu Y, Awai K, Inoue M, Watai R, Sano T, Hasegawa H, Nishimura Y (2005) MDCT of hypervascular hepatocellular carcinomas: a prospective study using contrast materials with different iodine concentrations. AJR Am J Roentgenol 184:1535–1540PubMedGoogle Scholar
  33. 33.
    Sica GT, Ji H, Ros PR (2000) CT and MR imaging of hepatic metastases. AJR Am J Roentgenol 174:691–698PubMedGoogle Scholar
  34. 34.
    Urban BA, Fishman EK, Kuhlman JE, Kawashima A, Hennessey JG, Siegelman SS (1993) Detection of focal hepatic lesions with spiral CT: comparison of 4- and 8-mm interscan spacing. AJR Am J Roentgenol 160:783–785PubMedGoogle Scholar
  35. 35.
    Obuchowski NA (2003) Receiver operating characteristic curves and their use in radiology. Radiology 229:3–8PubMedCrossRefGoogle Scholar
  36. 36.
    Zweig MH, Campbell G (1993) Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem 39:561–577PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Young Kon Kim
    • 1
    Email author
  • Seog Wan Ko
    • 1
  • Seung Bae Hwang
    • 1
  • Chong Soo Kim
    • 1
  • Hee Chul Yu
    • 2
  1. 1.Department of Diagnostic RadiologyChonbuk National University Hospital and Medical SchoolJeon JuSouth Korea
  2. 2.Department of General SurgeryChonbuk National University Hospital and Medical SchoolJeon JuSouth Korea

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