Comparison of Ferucarbotran-Enhanced MRI and Triple- Phase MDCT for the Detection of Hepatocellular Carcinoma in Advanced Liver Cirrhosis

Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine Department of Radiology, Kangwon National University College of Medicine Department of Radiology, Korea University Guro Hospital Received October 12, 2007 ; Accepted November 2, 2007 Address reprint requests to : Seung Hoon Kim, M.D., Department of Radiolgy, Samsung Medical Center, 50 Ilwon-dong, Kangnam-ku, Seoul 135-170, Korea Tel. 82-2-3410-2542 Fax. 82-2-3410-2559 E-mail: [email protected] Purpose: To compare the diagnostic performance of ferucarbotran-enhanced MRI at 1.5-T with triple-phase multidetector-row helical CT (MDCT) to detect hepatocellular carcinoma in patients with advanced liver cirrhosis. Materials and Methods: Twenty patients with advanced liver cirrhosis (Child’s class B:C = 8:12) underwent ferucarbotran-enhanced MRI and triple-phase MDCT prior to liver transplantation. The mean time interval between the two imaging techniques was 18 days (range, 1-35 days). Three radiologists independently reviewed both images on a lesion-by-lesion basis and interpreted them for comparison with the pathologic findings of the explanted livers. As well, the sensitivity and an alternative-free response receiver operating characteristics (ROC) analysis was used to evaluate the diagnostic performance of each technique. Results: The mean area under the ROC curve (Az) was significantly higher for the triple-phase MDCT (0.766) compared to the ferucarbotran-enhanced MRI (0.675) (p < 0.001). Similarly, the mean sensitivity of the triple-phase MDCT (60.3%) exceeded the ferucarbotran-enhanced MRI (43.1%). The results indicate that the triple-phase MDCT provides significantly greater mean sensitivity than the ferucarbotran-enhanced MRI (p < 0.001). Conclusion: The triple-phase MDCT provided a better diagnostic performance and higher sensitivity than the ferucarbotran-enhanced MRI for the detection of hepatocellular carcinomas in patients with advanced liver cirrhosis.