MnDPDP-enhanced MR imaging of the liver

Purpose: To compare lesion detection and characterisation predicted by MnDPDP-enhanced MR imaging with surgical excision and pathological examination. Material and Methods: Ninety patients were intravenously infused at a rate of 2 to 3 ml/min with 5 μmol/kg mangafodipir trisodium (MnDPDP, Teslascan). The patients were examined with spin-echo and gradient-echo T1-weighted MR imaging at 1 h and 24 h after the end of infusion. The results were compared with identical pre-contrast sequences. In 20 of these patients, the pre-operative MR findings were compared with intra-operative ultrasonography and histology of the resected liver specimens. Results: In those with liver metastases, there was a good correlation between MR and the hepatic disease in 11 out of 14 cases. In the group with primary liver tumours, MR findings correlated with hepatic disease in 5 out of 6 cases. Conclusion: Liver lesion characterisation is possible with MnDPDP, and MR contrast enhancement with this agent is considered to be an important adjunct to the radiological assessment of patients with neoplastic liver disease where accurate decisions for surgical planning are imperative.

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Robotic enucleation of a biliary adenofibroma

BMJ Case Reports ◽

10.1136/bcr-2021-242737 ◽

2021 ◽

Vol 14 (8) ◽

pp. e242737

Author(s):

Elizabeth Blears ◽

Tadahiro Uemura ◽

Mark Bunker

Keyword(s):

Eastern Cooperative Oncology Group ◽

Surgical Excision ◽

Liver Lesion ◽

Pathological Examination ◽

Malignant Degeneration ◽

Multilocular Cyst ◽

Group Score ◽

Biliary Adenofibroma ◽

Cystic Liver ◽

Work Up

A 69-year-old man was referred to the hepatobiliary surgeons for mild enlargement of an asymptomatic cystic liver lesion found on routine screening in 2017 that measured 3.7×3.6×4.3 cm. Work-up with MRI revealed a complex multilocular cyst that had enlarged to 6.6×5.5×4.6 cm. Other work-up was unremarkable. He had a Eastern Cooperative Oncology Group score of 1; therefore, a surgical excision was planned due to the possibility for malignancy. A robotic approach with enucleation of the lesion was undertaken, with plans for return for a wider resection if pathological examination revealed malignancy. The lesion was noted to be a biliary adenofibroma, an exceptionally rare lesion that is thought to be benign, but requires excision due to potential malignant degeneration. The patient was discharged home the following day and has had minimal pain in his postoperative course.

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Comparison of inversion recovery fast spin-echo (FSE) with T2-weighted fat-saturated FSE and T1-weighted MR imaging in bone marrow lesion detection

Skeletal Radiology ◽

10.1007/s002560050052 ◽

1996 ◽

Vol 25 (2) ◽

pp. 149-152 ◽

Cited By ~ 20

Author(s):

M. H. Pui ◽

S. K. Chang

Keyword(s):

Bone Marrow ◽

Mr Imaging ◽

Spin Echo ◽

Bone Marrow Lesion ◽

Lesion Detection ◽

Inversion Recovery ◽

Fast Spin Echo ◽

Fast Spin

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MnDPDP for MR imaging of the liver

Acta Radiologica ◽

10.1080/02841859709172394 ◽

1997 ◽

Vol 38 (5) ◽

pp. 638-642 ◽

Cited By ~ 12

Author(s):

E. J. Rummeny ◽

C. G. Torres ◽

J. C. Kurdziel ◽

G. Nilsen ◽

B. Op de Beeck ◽

...

Keyword(s):

Mr Imaging ◽

Spin Echo ◽

Lesion Detection ◽

Phase Iii ◽

Gradient Echo ◽

Mr Images ◽

Diagnostic Efficacy ◽

Post Contrast ◽

Independent Evaluation ◽

Before And After

Purpose: To evaluate the diagnostic efficacy of mangafodipir trisodium (MnDPDP, Teslascan) as a new contrast agent for MR imaging of the liver based on an independent evaluation of the MR images from the European phase III studies. Material and Methods: MR imaging of the liver was done at 0.5–2.0 T in 17 European centres and included T1-weighted spin-echo and gradient-echo sequences before and after administration of MnDPDP to patients at a dose of 5 μmol/kg b.w. T2-weighted images were also obtained in all cases before the i.v. injection of the agent. Images of a total of 592 patients were evaluated by 4 independent experienced radiologists who were not involved in the on-site clinical trials. Results: Statistically significantly more lesions were detected (p = 0.0014) in MnDP-DP-enhanced T1-weighted MR images than in unenhanced images. T1-weighted gradient-echo sequences were found to be superior to T1-weighted spin-echo sequences after injection of MnDPDP. The post-contrast images were found to be statistically significantly superior to the pre-contrast images in confidence in the presence of a lesion ( p≤ 0.0001), quality of lesion delineation ( p≤ 0.0001), lesion conspicuity ( p ≤ 0.0001) and in the confidence in the diagnosis of a lesion (p = 0.001). Conclusion: This independent evaluation of the European phase III trials confirmed the superiority of MnDPDP-enhanced MR images over unenhanced images for lesion detection and characterization.

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