Detection of hepatic metastases using ferucarbotran-enhanced MR imaging: Feasibility and diagnostic accuracy of three-dimensional sensitivity-encoding water-excitation multishot echo-planar sequence (3D-SWEEP)

Purpose: To evaluate the diagnostic accuracy of a ferucarbotran-enhanced three-dimensional sensitivity-encoding water-excitation multishot echo-planar sequence (3D-SWEEP) for detecting hepatic metastases compared to a T2*-weighted fast field-echo (FFE) sequence. Materials and Methods: Twenty-five consecutive patients with hepatic metastases underwent ferucarbotran-enhanced MRI on a 1.5-T unit before hepatic resections. Eighty-two foci of metastases were confirmed by histopathology or intraoperative ultrasonography (US). Signal-intensity decay (SID), tumor-to-liver contrast (TLC), and image quality were compared between T2*-weighted FFE and 3D-SWEEP. Three independent observers reviewed three imaging sets: set 1, without 3D-SWEEP or T2*-weighted FFE; set 2, with T2*-weighted FFE; and set 3, with 3D-SWEEP. The mean values of areas under alternative free response receiver operating characteristic curves (Az) and sensitivities were compared among the three sets. Results: SID and TLC were significantly greater for 3D-SWEEP than T2*-weighted FFE, although 3D-SWEEP had poorer image quality. The mean Az and sensitivity were significantly greater for set 3 compared to set I for detecting overall lesions, and compared to sets I and 2 for detecting lesions of 1-2 cm in diameter. Conclusion: Despite relatively prominent artifacts, ferucarbotran-enhanced 3D-SWEEP was more sensitive and accurate than T2*-weighted FFE for detecting hepatic metastases.