European Radiology

, 18:457 | Cite as

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

  • Renate Hammerstingl
  • Alexander Huppertz
  • Josy Breuer
  • Thomas Balzer
  • Anthony Blakeborough
  • Rick Carter
  • Lluis Castells Fusté
  • Gertraud Heinz-Peer
  • Werner Judmaier
  • Michael Laniado
  • Riccardo M. Manfredi
  • Didier G. Mathieu
  • Dieter Müller
  • Koenraad Mortelè
  • Peter Reimer
  • Maximilian F. Reiser
  • Philip J. Robinson
  • Kohkan Shamsi
  • Michael Strotzer
  • Matthias Taupitz
  • Bernd Tombach
  • Gianluca Valeri
  • Bernhard E. van Beers
  • Thomas J. Vogl
  • For the European EOB-study group
Hepatobiliary-Pancreas

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 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Renate Hammerstingl
    • 1
  • Alexander Huppertz
    • 2
  • Josy Breuer
    • 3
  • Thomas Balzer
    • 3
  • Anthony Blakeborough
    • 4
  • Rick Carter
    • 5
  • Lluis Castells Fusté
    • 6
  • Gertraud Heinz-Peer
    • 7
  • Werner Judmaier
    • 8
  • Michael Laniado
    • 9
  • Riccardo M. Manfredi
    • 10
  • Didier G. Mathieu
    • 11
  • Dieter Müller
    • 13
  • Koenraad Mortelè
    • 12
  • Peter Reimer
    • 14
  • Maximilian F. Reiser
    • 15
  • Philip J. Robinson
    • 16
  • Kohkan Shamsi
    • 17
  • Michael Strotzer
    • 18
  • Matthias Taupitz
    • 19
  • Bernd Tombach
    • 20
  • Gianluca Valeri
    • 21
  • Bernhard E. van Beers
    • 22
  • Thomas J. Vogl
    • 23
  • For the European EOB-study group
  1. 1.Institute of Diagnostic and Interventional RadiologyJohann Wolfgang Goethe-UniversityFrankfurt am MainGermany
  2. 2.Imaging Science Institute, Charitè - SiemensBerlinGermany
  3. 3.Gobal Clinical Development Diagnostics, Bayer Schering Pharma AGBerlinGermany
  4. 4.Department of RadiologyRoyal Hallamshire HospitalSheffieldUK
  5. 5.Bayer Health Care Ltd.Burgess HillUK
  6. 6.Liver Unit, Department of Internal MedicineHospital Vall d`HebrònBarcelonaSpain
  7. 7.Allg. Krankenhaus der Stadt WienUniversitätsklinik für RadiodiagnostikWienGermany
  8. 8.Department of Magnetic Resonance Imaging and SpectroscopyUniversity Hospital InnsbruckInnsbruckAustria
  9. 9.Institute for Diagnostic RadiologyUniversitätsklinikum Carl Gustav Carus, Technische Universität DresdenDresdenGermany
  10. 10.Department of RadiologyPoliclinico, University of VeronaVeronaItaly
  11. 11.Centre d’ImagerieAix en ProvenceFrance
  12. 12.Department of Radiology (L1)Brigham and Women’s HospitalBostonUSA
  13. 13.Department of RadiologyGeorg-August UniversitätGöttingenGermany
  14. 14.Department of RadiologyKlinikum KarlsruheKarlsruheGermany
  15. 15.Institute of Clinical RadiologyLudwig-Maximilians-University Munich - Klinikum GrosshadernMunichGermany
  16. 16.Department of Clinical RadiologySt James’s University HospitalLeedsUK
  17. 17.Corporate Clinical OperationsBerlex Laboratories Inc.MontvilleUSA
  18. 18.Department of Diagnostic RadiologyUniversity HospitalRegensburgGermany
  19. 19.Department of RadiologyUniversitätsklinikum Charitè, Med. Fakultät der Humboldt-UniversitätBerlinGermany
  20. 20.Institute of Clinical RadiologyWestfälische Wilhelms Universität MünsterMünsterGermany
  21. 21.Department of RadiologyUniversity of Ancona, Regional Hospital Torette, Via Conca, ToretteAnconaItaly
  22. 22.Department of RadiologyUniversité Catholique de Louvain, St-Luc University HospitalBrusselsBelgium
  23. 23.Institute of Diagnostic and Interventional RadiologyJohann Wolfgang Goethe-UniversityFrankfurt am MainGermany

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