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Gadoxetic acid-enhanced MRI and diffusion-weighted imaging for the detection of colorectal liver metastases after neoadjuvant chemotherapy

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate the diagnostic performance of gadoxetic acid-enhanced MRI including diffusion-weighted imaging (DWI) for the detection of colorectal liver metastases (CRLMs) after neoadjuvant chemotherapy (NAC).

Methods

Our study population comprised 77 patients with 140 CRLMs who underwent gadoxetic acid-enhanced MRI within 1 month prior to surgery: group A (without NAC, n = 38) and group B (with NAC, n = 39). Two radiologists independently assessed all MR images and graded their diagnostic confidence for CRLM on a 5-point scale. Diagnostic accuracy, sensitivity and positive predictive values (PPV) were calculated and compared between the two groups.

Results

Diagnostic accuracy of gadoxetic acid-enhanced MRI in group B was slightly lower than in group A, but a statistically significant difference was not observed (observer 1: A z, 0.926 in group A, 0.905 in group B; observer 2: A z, 0.944 in group A, 0.885 in group B; p > 0.05). Sensitivity and PPV of group B were comparable to those of group A (observer 1: sensitivity = 93.5 % vs. 93.6 %, PPV = 95.1 % vs. 86.9 %; observer 2: sensitivity = 96.8 % vs. 91.0 %; PPV = 90.0 % vs. 89.7 %; all p > 0.05).

Conclusions

Gadoxetic acid-enhanced MRI including DWI provided good diagnostic performance with high sensitivity (>90 %) for the detection of CRLMs, regardless of the influence of NAC.

Key Points

• Gadoxetic acid-enhanced MRI including DWI shows high sensitivity for CRLMs.

• Chemotherapy does not influence the diagnostic performance of liver MRI for CRLMs.

• Gadoxetic acid-enhanced MRI can be used for evaluation of CRLMs after NAC.

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Abbreviations

CRLM:

Colorectal liver metastases

DWI:

Diffusion-weighted imaging

HBP:

Hepatobiliary phase

NAC:

Neoadjuvant chemotherapy

PPV:

Positive predictive value

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Acknowledgments

The scientific guarantor of this publication is Prof. Jeong Min Lee. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This work was supported by Research Settlement Fund for the new faculty of SNU (No 800-20140181). The Medical Research Collaboration Center (Seoul National University Hospital) kindly provided statistical advice for this manuscript. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, case-control study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Konkuk University Medical Center, Seoul, Korea

    Mi Hye Yu

  2. Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea

    Jeong Min Lee, Joon Koo Han & Byung-Ihn Choi

  3. Department of Radiology, Boramae Medical Center, Seoul, Korea

    Bo Yun Hur

  4. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea

    Tae-You Kim

  5. Department of Surgery, Seoul National University Hospital, Seoul, Korea

    Seung-Yong Jeong, Nam-Joon Yi & Kyung-Suk Suh

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  1. Mi Hye Yu
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Correspondence to Jeong Min Lee.

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Yu, M.H., Lee, J.M., Hur, B.Y. et al. Gadoxetic acid-enhanced MRI and diffusion-weighted imaging for the detection of colorectal liver metastases after neoadjuvant chemotherapy. Eur Radiol 25, 2428–2436 (2015). https://doi.org/10.1007/s00330-015-3615-5

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  • DOI: https://doi.org/10.1007/s00330-015-3615-5

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