Detection of hepatocellular carcinoma by ferumoxides-enahanced MR imaging in cirrhosis: Incremental value of dynamic gadolinium-enhancement

Aliya Qayyum, Ruedi F. Thoeni, Fergus V. Coakley, Ying Lu, Jeff P. Quay, Linda D. Ferrell

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose: To investigate the incremental value of dynamic gadolinium-enhancement performed immediately after ferumoxides-enhanced magnetic resonance (MR) imaging on the detection of hepatocellular carcinoma in patients with cirrhosis. Materials and Methods: We retrospectively reviewed MR scans of 62 cirrhotic patients over a two-year period. Sequences included ferumoxides-enhanced T2-weighted fast spin echo followed by dynamic gadolinium-enhanced T1-weighted spoiled gradient echo. Two readers independently documented the presence of hepatocellular carcinoma on a three-point confidence scale, without and with gadolinium-enhanced images. The presence or absence of hepatocellular carcinoma was established by histopathology (58 patients) or follow-up imaging (four patients) over a mean period of nine months. Results: A total of 71 hepatocellular carcinomas were found in 42 patients. There was no statistically significant difference in sensitivity for the diagnosis of hepatocellular carcinoma without vs. with gadolinium-enhanced images (68% vs. 74% for reader 1 and 62% vs. 73% for reader 2, respectively, P > 1.3). However, both readers showed a lower mean confidence for tumor detection without vs. with gadolinium-enhanced images (2.3 vs. 2.7 for reader 1, 2.3 vs. 2.9 for reader 2, P < 0.01). Conclusion: In our study, the addition of dynamic gadolinium-enhancement to ferumoxides-enhanced MR imaging did not improve hepatocellular carcinoma detection, but the addition of gadolinium-enhancement is recommended if ferumoxides-enhanced imaging is used because it increased reader confidence.

Original languageEnglish (US)
Pages (from-to)17-22
Number of pages6
JournalJournal of Magnetic Resonance Imaging
Issue number1
StatePublished - Jan 2006
Externally publishedYes


  • Cirrhosis
  • Ferumoxide
  • Liver
  • Magnetic resonance (MR)
  • Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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