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Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions

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Abstract

A multicenter study has been employed to evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) using the new liver-specific contrast agent gadoxetic acid (Gd-EOB-DTPA, Primovist), as opposed to contrast-enhanced biphasic spiral computed tomography (CT), in the diagnosis of focal liver lesions, compared with a standard of reference (SOR). One hundred and sixty-nine patients with hepatic lesions eligible for surgery underwent Gd-EOB-DTPA-enhanced MRI as well as CT within 6 weeks. Pathologic evaluation of the liver specimen combined with intraoperative ultrasound established the SOR. Data sets were evaluated on-site (14 investigators) and off-site (three independent blinded readers). Gd-EOB-DTPA was well tolerated. Three hundred and two lesions were detected in 131 patients valid for analysis by SOR. The frequency of correctly detected lesions was significantly higher on Gd-EOB-DTPA-enhanced MRI compared with CT in the clinical evaluation [10.44%; 95% confidence interval (CI): 4.88, 16.0]. In the blinded reading there was a trend towards Gd-EOB-DTPA-enhanced MRI, not reaching statistical significance (2.14%; 95% CI: -4.32, 8.6). However, the highest rate of correctly detected lesions with a diameter below 1 cm was achieved by Gd-EOB-DTPA-enhanced MRI. Differential diagnosis was superior for Gd-EOB-DTPA-enhanced MRI (82.1%) versus CT (71.0%). A change in surgical therapy was documented in 19  More>>
Authors:
Hammerstingl, Renate; Vogl, Thomas J; [1]  Huppertz, Alexander; [2]  Breuer, Josy; Balzer, Thomas; [3]  Blakeborough, Anthony; [4]  Carter, Rick; [5]  Castells Fuste, Lluis; [6]  Heinz-Peer, Gertraud; [7]  Judmaier, Werner; [8]  Laniado, Michael; [9]  Manfredi, Riccardo M; [10]  Mathieu, Didier G; [11]  Mueller, Dieter; [12]  Mortele, Koenraad; [13]  Reimer, Peter; [14]  Reiser, Maximilian F; [15]  Robinson, Philip J; [16]  Shamsi, Kohkan; [17]  Strotzer, Michael; [18]  Taupitz, Matthias; [19]  Tombach, Bernd; Valeri, Gianluca; Beers, Bernhard E. van [20] 
  1. Johann Wolfgang Goethe-Univ., Inst. of Diagnostic and Interventional Radiology, Frankfurt am Main (Germany)
  2. Imaging Science Inst., Charite - Siemens, Berlin (Germany)
  3. Gobal Clinical Development Diagnostics, Bayer Schering Pharma AG, Berlin (Germany)
  4. Royal Hallamshire Hospital, Dept. of Radiology, Sheffield (United Kingdom)
  5. Bayer Health Care Ltd., Burgess Hill, West Sussex (United Kingdom)
  6. Hospital Vall d'Hebron, Liver Unit, Dept. of Internal Medicine, Barcelona (Spain)
  7. Universitaetsklinik fuer Radiodiagnostik, Allg. Krankenhaus der Stadt Wien, Wien (Germany)
  8. Univ. Hospital Innsbruck, Dept. of Magnetic Resonance Imaging and Spectroscopy, Innsbruck (Austria)
  9. Universitaetsklinikum Carl Gustav Carus, Technische Univ. Dresden, Inst. for Diagnostic Radiology, Dresden (Germany)
  10. Univ. of Verona, Dept. of Radiology, Verona (Italy)
  11. Centre d'Imagerie, Aix en Provence (France)
  12. Georg-August Univ., Dept. of Radiology, Goettingen (Germany)
  13. Brigham and Women's Hospital, Dept. of Radiology (L1), Boston, MA (United States)
  14. Klinikum Karlsruhe, Dept. of Radiology, Karlsruhe (Germany)
  15. Ludwig-Maximilians-Univ. Munich - Klinikum Grosshadern, Inst. of Clinical Radiology, Munich (Germany)
  16. St James's Univ. Hospital, Dept. of Clinical Radiology, Leeds (United Kingdom)
  17. Berlex Labs. Inc., Montville, NJ (United States)
  18. Univ. Hospital, Dept. of Diagnostic Radiology, Regensburg (Germany)
  19. Universitaetsklinikum Charite, Med. Fakultaet der Humboldt-Univ., Dept. of Radiology, Berlin (Germany)
  20. and others
Publication Date:
Mar 15, 2008
DOI:
https://doi.org/10.1007/S00330-007-0716-9
Product Type:
Journal Article
Resource Relation:
Journal Name: European Radiology; Journal Volume: 18; Journal Issue: 3; Other Information: European EOB-study group
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; COMPARATIVE EVALUATIONS; COMPUTERIZED TOMOGRAPHY; DIGESTIVE SYSTEM DISEASES; LIVER; NMR IMAGING; THERAPY
OSTI ID:
21001690
Country of Origin:
Germany
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0938-7994; EURAE3; TRN: DE08F3457
Availability:
Available from: http://dx.doi.org/10.1007/s00330-007-0716-9
Submitting Site:
DEN
Size:
page(s) 457-467
Announcement Date:
Apr 14, 2008

Journal Article:

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Citation Formats

Hammerstingl, Renate, Vogl, Thomas J, Huppertz, Alexander, Breuer, Josy, Balzer, Thomas, Blakeborough, Anthony, Carter, Rick, Castells Fuste, Lluis, Heinz-Peer, Gertraud, Judmaier, Werner, Laniado, Michael, Manfredi, Riccardo M, Mathieu, Didier G, Mueller, Dieter, Mortele, Koenraad, Reimer, Peter, Reiser, Maximilian F, Robinson, Philip J, Shamsi, Kohkan, Strotzer, Michael, Taupitz, Matthias, Tombach, Bernd, Valeri, Gianluca, and Beers, Bernhard E. van. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions. Germany: N. p., 2008. Web. doi:10.1007/S00330-007-0716-9.
Hammerstingl, Renate, Vogl, Thomas J, Huppertz, Alexander, Breuer, Josy, Balzer, Thomas, Blakeborough, Anthony, Carter, Rick, Castells Fuste, Lluis, Heinz-Peer, Gertraud, Judmaier, Werner, Laniado, Michael, Manfredi, Riccardo M, Mathieu, Didier G, Mueller, Dieter, Mortele, Koenraad, Reimer, Peter, Reiser, Maximilian F, Robinson, Philip J, Shamsi, Kohkan, Strotzer, Michael, Taupitz, Matthias, Tombach, Bernd, Valeri, Gianluca, & Beers, Bernhard E. van. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions. Germany. https://doi.org/10.1007/S00330-007-0716-9
Hammerstingl, Renate, Vogl, Thomas J, Huppertz, Alexander, Breuer, Josy, Balzer, Thomas, Blakeborough, Anthony, Carter, Rick, Castells Fuste, Lluis, Heinz-Peer, Gertraud, Judmaier, Werner, Laniado, Michael, Manfredi, Riccardo M, Mathieu, Didier G, Mueller, Dieter, Mortele, Koenraad, Reimer, Peter, Reiser, Maximilian F, Robinson, Philip J, Shamsi, Kohkan, Strotzer, Michael, Taupitz, Matthias, Tombach, Bernd, Valeri, Gianluca, and Beers, Bernhard E. van. 2008. "Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions." Germany. https://doi.org/10.1007/S00330-007-0716-9.
@misc{etde_21001690,
title = {Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions}
 author = {Hammerstingl, Renate, Vogl, Thomas J, Huppertz, Alexander, Breuer, Josy, Balzer, Thomas, Blakeborough, Anthony, Carter, Rick, Castells Fuste, Lluis, Heinz-Peer, Gertraud, Judmaier, Werner, Laniado, Michael, Manfredi, Riccardo M, Mathieu, Didier G, Mueller, Dieter, Mortele, Koenraad, Reimer, Peter, Reiser, Maximilian F, Robinson, Philip J, Shamsi, Kohkan, Strotzer, Michael, Taupitz, Matthias, Tombach, Bernd, Valeri, Gianluca, and Beers, Bernhard E. van}
 abstractNote = {A multicenter study has been employed to evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) using the new liver-specific contrast agent gadoxetic acid (Gd-EOB-DTPA, Primovist), as opposed to contrast-enhanced biphasic spiral computed tomography (CT), in the diagnosis of focal liver lesions, compared with a standard of reference (SOR). One hundred and sixty-nine patients with hepatic lesions eligible for surgery underwent Gd-EOB-DTPA-enhanced MRI as well as CT within 6 weeks. Pathologic evaluation of the liver specimen combined with intraoperative ultrasound established the SOR. Data sets were evaluated on-site (14 investigators) and off-site (three independent blinded readers). Gd-EOB-DTPA was well tolerated. Three hundred and two lesions were detected in 131 patients valid for analysis by SOR. The frequency of correctly detected lesions was significantly higher on Gd-EOB-DTPA-enhanced MRI compared with CT in the clinical evaluation [10.44%; 95% confidence interval (CI): 4.88, 16.0]. In the blinded reading there was a trend towards Gd-EOB-DTPA-enhanced MRI, not reaching statistical significance (2.14%; 95% CI: -4.32, 8.6). However, the highest rate of correctly detected lesions with a diameter below 1 cm was achieved by Gd-EOB-DTPA-enhanced MRI. Differential diagnosis was superior for Gd-EOB-DTPA-enhanced MRI (82.1%) versus CT (71.0%). A change in surgical therapy was documented in 19 of 131 patients (14.5%) post Gd-EOB-DTPA-enhanced MRI. Gd-EOB-DTPA-enhanced MRI was superior in the diagnosis and therapeutic management of focal liver lesions compared with CT. (orig.)}
 doi = {10.1007/S00330-007-0716-9}
 journal = []
 issue = {3}
 volume = {18}
 place = {Germany}
 year = {2008}
 month = {Mar}
 }