MR and CT draw even in imaging liver malignancies

Researchers gave MR and CT a split verdict in their relative abilities to image liver malignances during a scientific session Saturday.

A team from Heidleberg University said MR arterioportography had a higher sensitivity and specificity than CT arterioportography in the detection of primary and secondary liver lesions.

A team from Helinski University found that multislice CT edged MR and was nearly equal to intraoperative ultrasound in the assessment of malignant liver lesions.

A team from the University of Pisa looked at combined strategies and gave the edge to paramagnetic contrast-enhanced MR with contrast ultrasound over CT and ultrasound for the characterization of small liver lesions.

The MR and CT arterioportography study compared results in 15 patients and scheduled for surgery. Both unenhanced and enhanced images were obtained. The images were read by three observers and malignancy confirmed with surgery and pathology.

The CT scans were found to have a sensitivity of 90% and a specificity of 60%. The MR scans had a sensitivity of 96% and a specificity of 83%. In addition, diagnostic confidence was higher with the MR images, the researchers said.

The study at the Helinski University compared multiphasic multislice CT and gadolinium-enhanced MR in 31 patients scheduled for surgery. Intraoperative ultrasound and palpation revealed 45 solid liver lesions. The CT scans revealed 43 of lesions and the MR scans revealed 35. Lesion vascular proximity was correctly identified by CT in 97% of the patients and by MR in 87%, the researchers said. Both modalities, however, performed relatively poorly in detecting extrahapatic disease.

The study at the University of Pisa compared contrast ultrasound, multidetector CT, and superparamagnetic MR in 40 patients. A combination of pathology and imaging findings identified 67 lesions. Images were reviewed by two blinded readers. Both readers identified more of the lesions on MR than with either other modality. Using a combined ultrasound and MR reading strategy produced the best results, the researchers said.