HEPATIC METASTASES AND CAVERNOUS HEMANGIOMAS - DISTINCTION WITH STANDARD-DOSE AND TRIPLE-DOSE GADOTERIDOL-ENHANCED MR-IMAGING

PURPOSE: To determine if hepatic metastases can be distinguished from cavernous hemangiomas by pattern analysis pf magnetic resonance (MR) images obtained prior to and following administration of gadoteridol at standard (0.1 mmol/kg) and triple (0.3 mmol/kg) doses. MATERIALS AND METHODS: Ninety-five patients with proved hepatic metastases (n = 71) or cavernous hemangiomas (n = 24) underwent MR imaging at 16 different institutions. T2-weighted spin-echo and T1-weighted images were obtained before and after gadoteridol administration. Two independent blinded reviewers rated individual features of benignancy versus malignancy on a five-point confidence scale. RESULTS: The most useful diagnostic features, with 100% specificity, were nodular enhancement for hemangiomas and rim enhancement for metastases. Confident (definitely benign or definitely malignant) diagnoses were rendered in 80 of 95 cases (84%), with an accuracy of a confident diagnosis of 96%. CONCLUSION: The pattern of enhancement on T1-weighted images is highly accurate for distinction between hemangiomas and metastases in images obtained with both doses.