• Young Kon Kim, Chong Soo Kim, Young Hwan Lee, Hyo Sung Kwak, and Jeong Min Lee.
• Department of Diagnostic Radiology, Chonbuk National University Hospital, Conju, Korea.
• AJR Am J Roentgenol. 2004 May 1; 182 (5): 1217-23.

ObjectiveThe purpose of this study was to compare superparamagnetic iron oxide (SPIO)-enhanced MRI with gadobenate dimeglumine-enhanced MRI for the detection of hepatocellular carcinoma using receiver operating characteristic (ROC) analysis.Materials And MethodsTwenty-nine consecutive patients with 35 hepatocellular carcinomas underwent gadobenate dimeglumine-enhanced MRI (unenhanced, arterial, portal, and equilibrium phases) using 3D fat-saturated volumetric interpolated imaging and SPIO-enhanced MRI on a 1.5-T unit. SPIO-enhanced T2-weighted turbo spin-echo and T2*-weighted gradient-echo sequences were performed 48 hr after completion of the dynamic study. Three observers independently interpreted the images in random order, separately, and without patient identifiers. Diagnostic accuracy was evaluated using the alternative free response receiver operating characteristic method. Sensitivity and positive predictive value were also evaluated.ResultsThe mean sensitivity and positive predictive value of SPIO-enhanced imaging were 81.0% and 85.0%, respectively, and those of gadobenate dimeglumine-enhanced MRI were 91.4% and 88.1%, respectively. A significant difference was seen in the sensitivity of the two MRI examinations (p < 0.05). The mean value of the area under the ROC curve (A(z)) for gadobenate dimeglumine-enhanced imaging (A(z) = 0.97 +/- 0.01) was significantly higher than that for SPIO-enhanced imaging (A(z) = 0.90 +/- 0.02) (p = 0.004).ConclusionGadobenate dimeglumine-enhanced 3D dynamic imaging showed better diagnostic performance than SPIO-enhanced imaging for the detection of hepatocellular carcinomas.

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