Motosugi Utaroh, Ichikawa Tomoaki, Nakajima Hiroto, Sou Hironobu, Sano Mika, Sano Katsuhiro, Araki Tsutomu, Iino Hiroshi, Fujii Hideki, Nakazawa Tadao
Department of Radiology, University of Yamanashi, Chuo-shi, Yamanashi-ken, Japan.
J Comput Assist Tomogr. 2009 Mar-Apr;33(2):266-72. doi: 10.1097/RCT.0b013e31817f5c82.
PURPOSE: To compare the accuracy of dynamic contrast-enhanced multidetector-row computed tomography (CT) and superparamagnetic iron oxide-enhanced magnetic resonance imaging (MRI) in the evaluation of small hepatic metastases of colorectal carcinoma. MATERIALS AND METHODS: Of 94 patients with colorectal carcinoma analyzed, 76 hepatic metastases (<2 cm) were diagnosed in 17 patients. Superparamagnetic iron oxide (SPIO)-magnetic resonance (precontrast and postcontrast MRI) and dynamic contrast-enhanced multidetector-row CT (dynamic CT [precontrast, arterial, portal-venous, and delayed phase]) were evaluated. The alternative free-response receiver operating characteristic analysis was performed, and the sensitivities and positive predictive values were analyzed. RESULTS: The Az values and sensitivities of portal-venous phase CT, dynamic CT, and SPIO-MRI (0.62/59%, 0.69/61%, and 0.67/61%) were identical. The mean positive predictive value of dynamic CT (82%) was inferior to that of SPIO-MRI (91%). CONCLUSIONS: The diagnostic ability of dynamic CT is identical to that of SPIO-MRI in Az value and sensitivity. Superparamagnetic iron oxide-MRI should be recommended only if an equivocal lesion is detected by dynamic CT.
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