Superparamagnetic iron oxide hepatic MR imaging: efficacy and safety using conventional and fast spin-echo pulse sequences.

The purpose of this study was to evaluate the technical efficacy and safety of iv ferumoxides (Feridex), a superparamagnetic iron oxide contrast agent for detection of hepatic lesions using conventional spin-echo and fast spin-echo MR images. Precontrast and postcontrast MR studies were performed on 25 patients with suspected focal hepatic lesions. Conventional T1- and T2-weighted MR images, as well as fast spin-echo and fat suppressed fast spin-echo MR images, were evaluated. Quantitative assessment of the contrast agent was performed obtaining region of interest measurements of the liver, spleen, and selected hepatic lesions. The pulse sequences were also evaluated subjectively for overall image quality and a subjective assessment of lesion detection. The use of a superparamagnetic iron oxide contrast agent led to a decrease in hepatic signal intensity on all pulse sequences. Lesion-to-liver contrast increased 41.1%, 36.5%, and 32.0% on the conventional T2, fast spin-echo, and fat suppressed fast spin echo pulse sequences, respectively. Lesion-to-liver contrast decreased on the T1-weighted postcontrast pulse sequence by 23.8%. Despite improvement in lesion-to-liver contrast, radiologists subjectively preferred the precontrast sequences because of overall better image quality. At a dose of 10 mumol/kg, ferumoxides favorably impacts lesion-to-liver contrast, and may be useful in hepatic imaging, more with conventional T2-weighted spin-echo pulse sequences than with T2-weighted fast spin-echo pulse sequence.