Three-dimensional dynamic liver MR imaging using sensitivity encoding for detection of hepatocellular carcinomas: Comparison with superparamagnetic iron oxide-enhanced MR imaging

Purpose: To assess the diagnostic performance of three-dimensional dynamic liver imaging with sensitivity encoding (SENSE), including double arterial phase images and increased resolution, by comparing it to superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging for the detection of hypervascular hepatocellular carcinoma (HCC). Materials and Methods: Twenty-seven consecutive patients with 50 HCCs underwent Gd-BOPTA-enhanced dynamic imaging using SENSE and SPIO-enhanced MR imaging with at least a 24-hour interval between examinations. Using a three-dimensional gradient-echo technique applying SENSE, dynamic imaging consisting of double arterial phase-, portal phase- and delayed phase-images, was obtained. Using T2-weighted turbo spin-echo and T2*-weighted fast imaging with steady-state precession sequence, SPIO-enhanced MR imaging was obtained. For qualitative analysis, the diagnostic accuracy of both MR examinations for detecting the 50 HCCs was evaluated using the alternative free-response receiver operating characteristic method. Sensitivity and positive predictive value were also evaluated. Results: The mean sensitivity and positive predictive value of three-dimensional dynamic imaging with SENSE were 91.3% and 89.2%, respectively, and those of SPIO-enhanced imaging were 77.3% and 92.6 %, respectively. There was a significant difference in sensitivity between the two images (P < 0.05). The mean Az value of three-dimensional dynamic imaging with SENSE (0.97 ± 0.01) was significantly higher than that of SPIO-enhanced imaging (0.90 ± 0.02) (P = 0.00). Conclusion: Three-dimensional dynamic liver MR imaging using SENSE for acquiring double arterial phase images is more efficient than SPIO-enhanced MR imaging for detecting HCCs.