Abstract | BACKGROUND: Dynamic susceptibility contrast MR imaging (DSC-MRI) offers direct evaluation of neo-vascularity. Ferucarbotran does not accumulate in the interstitial space, instead remaining in the intravascular space during early phase imaging. We investigate tracer kinetic analysis with DSC-MRI with ferucarbotran and single level CT during hepatic arteriography (SL-CTHA) in assessment of hypervascular hepatocellular lesions and evaluate the usefulness of DSC-MRI with ferucarbotran. METHODS: Six patients having hypervascular hepatocellular carcinoma (HCC) and 3 patients having focal nodular hyperplasia (FNH) were included in the study. SL-CTHA was performed with the infusion of 3 mL of contrast media at a rate of 1 mL/s and scanned at a rate of 0.8 second per rotation. DSC-MRI was acquired with the echo-planar method at 1.5T system. A total dose of 1.4 mL (0.5 mol Fe/L) of ferucarbotran was used. Ferucarbotran was injected at a rate of 2 mL/s with 40 mL of physiological saline. Imaging was obtained at a temporal resolution of 1.2 or 0.46 seconds in 5 and 4 patients, respectively. For both CT and MRI modalities, a model-free analysis method was used to derive region of interest-based perfusion parameters. Plasma flow, distribution volume (DV) of contrast agent and estimated mean transit time (EMTT) were estimated. RESULTS: A strong correlation was obtained with plasma flow (r=0.8231, P=0.0064) between DSC-MRI and SL-CTHA. No significant correlation was obtained for DV and EMTT between DSC-MRI and SL-CTHA. All perfusion parameters showed no significant difference between SL-CTHA and DSC-MRI in FNH. On the other hand, in HCC, DV and EMTT showed significant differences (P=0.046 and 0.046), and plasma flow showed no significant difference between DSC-MRI and SL-CTHA. CONCLUSIONS: This pilot study demonstrates the possibility of quantitative analysis of liver tumor using superparamagnetic iron oxide ( SPIO)-based agent and highlights the potential for SPIO-based agent in more precisely assessing the perfusion characteristic of hypervascular liver tumors than by using extracellular contrast media.
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Authors | Kazuhiro Saito, Joseph Ledsam, Steven Sourbron, Yoichi Araki |
Journal | Quantitative imaging in medicine and surgery
(Quant Imaging Med Surg)
Vol. 10
Issue 6
Pg. 1298-1306
(Jun 2020)
ISSN: 2223-4292 [Print] China |
PMID | 32550138
(Publication Type: Journal Article)
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Copyright | 2020 Quantitative Imaging in Medicine and Surgery. All rights reserved. |