Hepatobiliary–Pancreas

European Radiology

, Volume 14, Issue 1, pp 14-20

Detection of colorectal liver metastases: a prospective multicenter trial comparing unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT

  • Carlo BartolozziAffiliated withDepartment of Radiology, University of Pisa Email author 
  • , Francescamaria DonatiAffiliated withDepartment of Radiology, University of Pisa
  • , Dania CioniAffiliated withDepartment of Radiology, University of Pisa
  • , Carlo ProcacciAffiliated withDepartment of Radiology, University of Verona
  • , Giovanni MoranaAffiliated withDepartment of Radiology, University of Verona
  • , Antonio ChiesaAffiliated withDepartment of Radiology, University of Brescia
  • , Luigi GrazioliAffiliated withDepartment of Radiology, University of Brescia
  • , Giorgio CittadiniAffiliated withDepartment of Radiology, University of Genova
  • , Giuseppe CittadiniAffiliated withDepartment of Radiology, University of Genova
    • , Andrea GiovagnoniAffiliated withDepartment of Radiology, University of Ancona
    • , Giovanni GandiniAffiliated withDepartment of Radiology, University of Torino
    • , Jochen MaassAffiliated withDepartment of Radiology, University of Torino
    • , Riccardo LencioniAffiliated withDepartment of Radiology, University of Pisa

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Abstract

The aim of this study was to compare unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT in the detection of hepatic colorectal metastases. Forty-four patients with hepatic colorectal metastases were examined with unenhanced and MnDPDP-enhanced MRI and with unenhanced and contrast-enhanced spiral CT. The MR examination protocol included baseline T1-weighted spin-echo (SE), T1-weighted gradient-recalled-echo (GRE), and T2-weighted fast-SE sequences; and T1-weighted SE and T1-weighted GRE sequences obtained 30–60 min after administration of 0.5 µmol/kg (0.5 ml/kg) mangafodipir trisodium (MnDPDP). Images were interpreted by three blinded readers. Findings at CT and MRI were compared with those at intraoperative US, which were used as term of reference. Intraoperative US detected 128 metastases. In a lesion-by-lesion analysis, the overall detection rate was 71% (91 of 128) for spiral CT, 72% (92 of 128) for unenhanced MRI, and 90% (115 of 128) for MnDPDP-enhanced MRI. MnDPDP-enhanced MRI was more sensitive than either unenhanced MRI (p<0.0001) or spiral CT (p=0.0007). In a patient-by-patient analysis, agreement with gold standard was higher for MnDPDP-enhanced MRI (33 of 44 cases) than for spiral CT (22 of 44 cases, p=0.0023) and unenhanced MRI (21 of 44 cases, p=0.0013). MnDPDP-enhanced MRI is superior to unenhanced MRI and spiral CT in the detection of hepatic colorectal metastases.

Keywords

Liver neoplasms Computed tomography Metastases Magnetic resonance Contrast media Mangafodipir trisodium