Hepatic metastases and cavernous hemangiomas: distinction with standard- and triple-dose gadoteridol-enhanced MR imaging.

PURPOSE

To determine if hepatic metastases can be distinguished from cavernous hemangiomas by pattern analysis of magnetic resonance (MR) images obtained prior to and following administration of gadoteridol at standard (0.1 mmol/kg) and triple (0.3 mmol/kg) doses.

MATERIALS AND METHODS

Ninety-five patients with proved hepatic metastases (n = 71) or cavernous hemangiomas (n = 24) underwent MR imaging at 16 different institutions. T2-weighted spin-echo and T1-weighted images were obtained before and after gadoteridol administration. Two independent blinded reviewers rated individual features of benignancy versus malignancy on a five-point confidence scale.

RESULTS

The most useful diagnostic features, with 100% specificity, were nodular enhancement for hemangiomas and rim enhancement for metastases. Confident (definitely benign or definitely malignant) diagnoses were rendered in 80 of 95 cases (84%), with an accuracy of a confident diagnosis of 96%.

CONCLUSION

The pattern of enhancement on T1-weighted images is highly accurate for distinction between hemangiomas and metastases in images obtained with both doses.