The role of SPIO-enhanced MRI in the detection of malignant liver lesions Pelin Savranoglu a , Funda Obuz a, 4 , Sebnem Karasu a , Ahmet Coker b , Mustafa Secil a , Ozgul Sagol c , Enis Igci a , Oguz Dicle a , Ibrahim Astarcioglu b a Department of Radiology, School of Medicine, Dokuz Eylul University, Izmir, Turkey b Department of Surgery, School of Medicine, Dokuz Eylul University, Izmir, Turkey c Department of Pathology, School of Medicine, Dokuz Eylul University, Izmir, Turkey Received 6 March 2006; accepted 2 June 2006 Abstract The aim of this study was to evaluate the efficacy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) in the detection of malignant liver tumors. MRI, using fast spin-echo T 2 -weighted and gradient-echo T 1 -weighted imagings before and after SPIO infusion, was performed in 32 patients with known or suspected hepatic lesions. Statistical analysis was performed using lesion-by- lesion analysis. SPIO-enhanced T 2 -weighted MRI showed results comparable to those of unenhanced T 2 -weighted MRI in the detection of focal liver lesions. D 2006 Elsevier Inc. All rights reserved. Keywords: Liver neoplasms, diagnosis; Magnetic resonance imaging; Superparamagnetic iron oxide 1. Introduction Detection of the precise number and localization of malignant hepatic lesions is important for the treatment planning of patients who are known to have primary or metastatic tumors in the liver. Although magnetic resonance imaging (MRI) has a high-contrast resolution, the efficiency of conventional sequences in determining lesions is limited. Contrast-enhanced MRI with extracellular agents has sig- nificantly improved the accuracy of the detection of malignant liver tumors [1]. Superparamagnetic iron oxide (SPIO), which is taken up by Kupffer cells, predominantly shortens T 2 or T 2 * relaxation time by disturbing the local magnetic field in the liver parenchyma. Most hepatic tumors lack Kupffer cells; therefore, the signal intensity of the tumors does not change after the administration of SPIO and after the lesion–liver contrast has increased. SPIO-enhanced MRI has been reported by many investigators as a method that is highly sensitive to the detection of liver tumors [2–9]. However, some studies have shown that there is no significant difference between unenhanced MRI and SPIO- enhanced MRI [10,11]. The purpose of this prospective study was to evaluate the efficiency of SPIO-enhanced MRI in the detection of malignant hepatic lesions in candidates for hepatic surgery. 2. Materials and methods 2.1. Patients Between May 2001 and September 2004, 39 patients with known or suspected primary or metastatic liver tumors [based on previous results of sonography or computerized tomography (CT) examinations] who were to undergo surgical procedure were included in the study. This study was approved by the institutional review board of our faculty, and written informed consent was obtained from all 0899-7071/06/$ – see front matter D 2006 Elsevier Inc. All rights reserved. doi:10.1016/j.clinimag.2006.06.001 4 Corresponding author. Huzur mah, Campete sok, Konak apt. no. 9/4, Narlidere, Izmir 35290, Turkey. Tel.: +90 232 2392400; fax: +90 232 2590541. E-mail address: fobuz@deu.edu.tr (F. Obuz). Clinical Imaging 30 (2006) 377 – 381