• Akihiro Nishie, Tsuyoshi Tajima, Kousei Ishigami, Yasuhiro Ushijima, Daisuke Okamoto, Masakazu Hirakawa, Yunosuke Nishihara, Akinobu Taketomi, Masamitsu Hatakenaka, Hiroyuki Irie, Kengo Yoshimitsu, and Hiroshi Honda.
• Department of Clinical Radiology, Kyushu University, Fukuoka, Japan. anishie@radiol.med.kyushu-u.ac.jp
• J Magn Reson Imaging. 2010 Feb 1; 31 (2): 373-82.

PurposeTo evaluate whether diffusion-weighted imaging (DWI) improves the detection of hepatocellular carcinoma (HCC) on super paramagnetic iron oxide (SPIO)-enhanced MRI.Materials And MethodsThis retrospective study group consisted of 30 patients with 50 HCC nodules who underwent MRI at 1.5 Tesla. Two combined MR sequence sets were compared for detecting HCC: SPIO-enhanced MRI (axial T2-weighted fast spin-echo (FSE) and T1-/T2*-weighted fast field echo (FFE) scanned before and after administration of ferucarbotran) and SPIO-enhanced MRI + DWI (SPIO-enhanced MRI with axial DWI scanned before and after administration of ferucarbotran). Three blinded readers independently reviewed for the presence of HCC on a segment-by-segment basis using a four-point confidence scale. The performance of the two combined MR sequence sets was evaluated using receiver operating characteristic (ROC) analysis.ResultsThe average area under the ROC curve (Az) of the three readers for the SPIO-enhanced MRI + DWI set (0.870 +/- 0.046) was significantly higher that that for the SPIO-enhanced MRI set (0.820 +/- 0.055) (P = .025). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detection of HCC were 66.0%, 98.0%, 90.0%, and 91.4%, respectively, for the SPIO-enhanced MRI set, and 70.0%, 98.6%, 92.9%, and 92.4%, respectively, for the SPIO-enhanced MRI + DWI set.ConclusionThe SPIO-enhanced MRI + DWI set outperformed the SPIO-enhanced MRI set for depicting HCC.

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