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Specificity of SPIO particles for characterization of liver hemangiomas using MRI

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Abstract

We investigated the specificity of superparamagnetic iron oxide (SPIO)–enhanced T1-weighted spin-echo (SE) magnetic resonance (MR) images for the characterization of liver hemangiomas. When imaging liver hemangiomas, which are the most frequent benign liver tumors, a method with very high specificity is required, which will obviate other studies, follow-up, or invasive diagnostic procedures such as percutaneous biopsy. Eighty-three lesions were examined by MR imaging at 1.5 T before and after intravenous injection of SPIO particles. Lesions were categorized as follows according to the final diagnosis: 37 hemangiomas, nine focal nodular hyperplasias (FNHs), 19 hepatocellular carcinomas (HCCs), and 18 metastases. Their signal intensity values were normalized to muscle and compared. The only lesions showing a significant increase in signal intensity ratio (lesion to muscle) on postcontrast T1-weighted SE images were hemangiomas (p < 0.001). The signal intensity ratio of hemangiomas increased on average by 70%. Based on receiver operating characteristic analysis and using a cutoff level of 50% signal increase, the specificity and sensitivity of SPIO-enhanced MR imaging for the characterization of hemangiomas would be 100% and 70%, respectively. The T1 effect of SPIO particles can help differentiate hemangiomas from other focal liver lesions such as FNHs, HCCs, and metastases and may obviate biopsy. When using SPIO particles for liver imaging, it is useful to add a T1-weighted sequence to T2-weighted images, thereby providing additional information for lesion characterization.

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Acknowledgements

The authors thank Dr Pierre Loubeyre and Dr Denis Mauget for their contribution to the analysis of the CT data. The authors also thank Prof. Alfredo Morabia for his help in the statistical analysis.

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Authors and Affiliations

  1. Division de Radiodiagnostic et de Radiologie Interventionnelle, HÒpital Universitaire de Genève, 24, rue Micheli-du-Crest, 1211 Geneva 14, Switzerland

    X. Montet, F. Lazeyras, N. Howarth, C. D. Becker, J.-P. Vallee & F. Terrier

  2. Clinique et Policlinique de Chirurgie Digestive, HÒpital Universitaire de Genève, 24, rue Micheli-du-Crest, 1211 Geneva 14, Switzerland

    G. Mentha

  3. Division de Pathologie Clinique, HÒpital Universitaire de Genève, 24, rue Micheli-du-Crest, 1211 Geneva 14, Switzerland

    L. Rubbia-Brandt

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  1. X. Montet
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Montet, X., Lazeyras, F., Howarth, N. et al. Specificity of SPIO particles for characterization of liver hemangiomas using MRI . Abdom Imaging 29, 60–70 (2004). https://doi.org/10.1007/s00261-003-0092-0

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