Purpose: To determine if hepatic metastases can be distinguished from cavernous hemangiomas by pattern analysis of 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.