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Detection of hepatic metastases: Gadolinium-enhanced MR imaging versus superparamagnetic iron oxide-enhanced MR imaging versus diffusion-weighted imaging
European Journal of Radiology 82 (2013) e50
Contents lists available at SciVerse ScienceDirect
European Journal of Radiology journal homepage: www.elsevier.com/locate/ejrad
Letter to the Editor Detection of hepatic metastases: Gadolinium-enhanced MR imaging versus superparamagnetic iron oxide-enhanced MR imaging versus diffusion-weighted imaging
Finally, we look forward to a future study on hepatic metastases combined the three diagnostic modalities, in which our inference will be verified.
I am interested in the article by Hekimoglu et al. in the March 2011 issue of European Journal of Radiology [1]. In their study, SPIOenhanced MRI and GbD-enhanced MRI were used in the detection of hepatic metastases. By contrast, in the author opinion, SPIO was recommended for the detection of hepatic metastases. Here, I would like to make some comments [1]. Evaluation of hepatic metastases is greatly significant for tumor stage, opportunity of surgical operation and outcome. Currently, various imaging methods are used for inspection of liver metastases, including ultrasound, enhanced CT, GbD-enhanced MRI, SPIO-enhanced MRI, diffusion-weighted imaging and PET/CT. As a radiologist, I am concerned which is the most suitable examination for the evaluation of hepatic metastases among GbD-enhanced MRI, SPIO-enhanced MRI, and diffusion-weighted imaging. In the Hekimoglu study, SPIO-enhanced MRI is confirmed easier to detect hepatic metastases than GbD-enhanced MRI with the sensitivity 100% [1]. In another study, Nasu et al. reported that the sensitivity and specificity of diffusion-weighted imaging were higher than those of SPIO-enhanced MRI (0.90 and 0.94 versus 0.66 and 0.82) in the detection of hepatic metastases [2]. Based on the above experimental results, we believe that diffusion-weighted imaging is superior to SPIO-enhanced MRI and GbD-enhanced MRI in the detection of hepatic metastases. Moreover, a recent experiment confirmed part of our inference. In the Soyer study, the use of diffusion-weighted imaging detected more hepatic metastases than that of GbD-enhanced MRI although there was no significant difference between them [3]. It is noted that the high sensitivity in the Hekimoglu study may be related to as they mentioned fewer cases and lack of pathological confirmation [1]. The high sensitivity of SPIO-enhanced MRI in the Hekimoglu study could be better convinced if they prove more definitive evidence. In addition, the SPIO used in human body should be cautious because further evaluation is needed in its safety.
Conflict of interest
0720-048X/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ejrad.2012.01.011
There is no conflict of interest. References [1] Hekimoglu K, Ustundag Y, Dusak A, et al. Small colorectal liver metastases: detection with SPIO-enhanced MRI in comparison with gadobenate dimeglumine-enhanced MRI and CT imaging. Eur J Radiol 2011;77(3):468–72. [2] Nasu K, Kuroki Y, Nawano S, et al. Hepatic metastases: diffusionweighted sensitivity-encoding versus SPIO-enhanced MR imaging. Radiology 2006;239(1):122–30. [3] Soyer P, Boudiaf M, Placé V, et al. Preoperative detection of hepatic metastases: comparison of diffusion-weighted T2-weighted fast spin echo and gadoliniumenhanced MR imaging using surgical and histopathologic findings as standard of reference. Eur J Radiol 2010;(July) [Epub ahead of print].
Qinghuan Liu Wenguang Liu Department of Emergent Surgery, Linyi People’s Hospital, 27# Jiefang Road, Linyi, Shandong 276000, China Wenjie Liang ∗ Shunliang Xu Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou Zhejiang 310003, China ∗ Corresponding author. Tel.: +86 57187236508. E-mail addresses: [email protected] (W. Liang), [email protected] (S. Xu)
19 April 2011
Contents lists available at SciVerse ScienceDirect
European Journal of Radiology journal homepage: www.elsevier.com/locate/ejrad
Letter to the Editor Detection of hepatic metastases: Gadolinium-enhanced MR imaging versus superparamagnetic iron oxide-enhanced MR imaging versus diffusion-weighted imaging
Finally, we look forward to a future study on hepatic metastases combined the three diagnostic modalities, in which our inference will be verified.
I am interested in the article by Hekimoglu et al. in the March 2011 issue of European Journal of Radiology [1]. In their study, SPIOenhanced MRI and GbD-enhanced MRI were used in the detection of hepatic metastases. By contrast, in the author opinion, SPIO was recommended for the detection of hepatic metastases. Here, I would like to make some comments [1]. Evaluation of hepatic metastases is greatly significant for tumor stage, opportunity of surgical operation and outcome. Currently, various imaging methods are used for inspection of liver metastases, including ultrasound, enhanced CT, GbD-enhanced MRI, SPIO-enhanced MRI, diffusion-weighted imaging and PET/CT. As a radiologist, I am concerned which is the most suitable examination for the evaluation of hepatic metastases among GbD-enhanced MRI, SPIO-enhanced MRI, and diffusion-weighted imaging. In the Hekimoglu study, SPIO-enhanced MRI is confirmed easier to detect hepatic metastases than GbD-enhanced MRI with the sensitivity 100% [1]. In another study, Nasu et al. reported that the sensitivity and specificity of diffusion-weighted imaging were higher than those of SPIO-enhanced MRI (0.90 and 0.94 versus 0.66 and 0.82) in the detection of hepatic metastases [2]. Based on the above experimental results, we believe that diffusion-weighted imaging is superior to SPIO-enhanced MRI and GbD-enhanced MRI in the detection of hepatic metastases. Moreover, a recent experiment confirmed part of our inference. In the Soyer study, the use of diffusion-weighted imaging detected more hepatic metastases than that of GbD-enhanced MRI although there was no significant difference between them [3]. It is noted that the high sensitivity in the Hekimoglu study may be related to as they mentioned fewer cases and lack of pathological confirmation [1]. The high sensitivity of SPIO-enhanced MRI in the Hekimoglu study could be better convinced if they prove more definitive evidence. In addition, the SPIO used in human body should be cautious because further evaluation is needed in its safety.
Conflict of interest
0720-048X/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ejrad.2012.01.011
There is no conflict of interest. References [1] Hekimoglu K, Ustundag Y, Dusak A, et al. Small colorectal liver metastases: detection with SPIO-enhanced MRI in comparison with gadobenate dimeglumine-enhanced MRI and CT imaging. Eur J Radiol 2011;77(3):468–72. [2] Nasu K, Kuroki Y, Nawano S, et al. Hepatic metastases: diffusionweighted sensitivity-encoding versus SPIO-enhanced MR imaging. Radiology 2006;239(1):122–30. [3] Soyer P, Boudiaf M, Placé V, et al. Preoperative detection of hepatic metastases: comparison of diffusion-weighted T2-weighted fast spin echo and gadoliniumenhanced MR imaging using surgical and histopathologic findings as standard of reference. Eur J Radiol 2010;(July) [Epub ahead of print].
Qinghuan Liu Wenguang Liu Department of Emergent Surgery, Linyi People’s Hospital, 27# Jiefang Road, Linyi, Shandong 276000, China Wenjie Liang ∗ Shunliang Xu Department of Radiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou Zhejiang 310003, China ∗ Corresponding author. Tel.: +86 57187236508. E-mail addresses: [email protected] (W. Liang), [email protected] (S. Xu)
19 April 2011