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MRI for Detection of Hepatocellular Carcinoma: Comparison of Mangafodipir Trisodium and Gadopentetate Dimeglumine Contrast Agents

¹ Department of Diagnostic Radiology, Chonbuk National University Hospital, Conju, South Korea.
² Department of Radiology and Institute of Radiation Medicine, Seoul National University Hospital, 28, Yongondong, Chongno-gu, Seoul 110-744, South Korea.

OBJECTIVE. The purpose of our study was to compare the performance of mangafodipir trisodium (Mn-DPDP)–enhanced and dynamic gadopentetate dimeglumine–enhanced MRI for the detection of hepatocellular carcinoma.

MATERIALS AND METHODS. Forty-six patients with 96 hepatocellular carcinomas underwent Mn-DPDP– and gadopentetate dimeglumine–enhanced MRI. The MRI examination included unenhanced T2-weighted turbo spin-echo and T1-weighted 2D fast low-angle shot (FLASH) sequences and a 3D FLASH sequence after the administration of gadopentetate dimeglumine and Mn-DPDP. Two observers reviewed three sets of images: a set of gadopentetate dimeglumine–enhanced MR images, a set of Mn-DPDP–enhanced MR images, and a combination of the gadopentetate dimeglumine and Mn-DPDP sets. Using receiver operating characteristic (ROC) analysis, imaging sets were compared for diagnostic accuracy and sensitivity.

RESULTS. The area under the ROC curve (A_z) was 0.942 for the gadopentetate dimeglumine–Mn-DPDP set, 0.932 for the gadopentetate dimeglumine set, and 0.877 for the Mn-DPDP set (p < 0.05). The mean sensitivity was greater for the gadopentetate dimeglumine set than for the Mn-DPDP set (87.5% vs 72.4%; p < 0.05). The false-negative rate of the Mn-DPDP set was statistically greater than that of the gadopentetate dimeglumine set (27.6% vs 12.5%). Most false-negative cases in the Mn-DPDP set were due to small (diameter < 2 cm), isoenhanced lesions.

CONCLUSION. Gadopentetate dimeglumine–enhanced MRI was superior to Mn-DPDP–enhanced MRI for the detection of hepatocellular carcinomas.

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