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Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?

  • Magnetic Resonance
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Abstract

Objectives

To compare diagnostic performance in the detection of colorectal liver metastases between 64-detector-row contrast-enhanced CT (CE-CT) alone and the combination of CE-CT and gadoxetic acid-enhanced MRI (EOB-MRI) at 3.0T, and to assess whether EOB-MRI in addition to CE-CT results in a change to initially planned operative strategy.

Methods

A total of 39 patients (27 men, mean age 65 years) with 85 histopathologically confirmed liver metastases were included. At EOB-MRI, unenhanced (T1- and T2-weighted), dynamic, and hepatocyte-phase images were obtained. At CE-CT, four-phase dynamic contrast-enhanced images were obtained. One on-site reader and three off-site readers independently reviewed both CE-CT alone and the combination of CE-CT and EOB-MRI. Sensitivity, positive predictive value, and alternative free-response receiver operating characteristic (AFROC) method were calculated. Differences in therapeutic strategy before and after the EOB-MRI examination were also evaluated.

Results

Sensitivity and area under the AFROC curve with the combination of CE-CT and EOB-MRI were significantly superior to those with CE-CT alone. Changes in surgical therapy were documented in 13 of 39 patients.

Conclusions

The combination of CE-CT and EOB-MRI may provide better diagnostic performance than CE-CT alone for the detection of colorectal liver metastases, and EOB-MRI in addition to CE-CT resulted in changes to the planned operative strategy in one-third of the patients.

Key Points

• Accurate preoperative imaging is essential for surgical planning and successful hepatic resection.

• Combination of CE-CT and EOB-MRI is useful to detect colorectal liver metastases.

• EOB-MRI combined with CE-CT contributes to determine the correct therapeutic strategy.

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Acknowledgments

The scientific guarantor of this publication is Masakatsu Tsurusaki. 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. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Division of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan

    Keitaro Sofue, Masakatsu Tsurusaki, Hiroyuki Tokue, Kentaro Shibamoto & Yasuaki Arai

  2. Department of Radiology, Graduate School of Medicine, Kobe University, Kobe, Japan

    Keitaro Sofue & Kazuro Sugimura

  3. Department of Radiology, Faculty of Medicine, Kinki University, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan

    Masakatsu Tsurusaki & Takamichi Murakami

  4. Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Tokyo, Japan

    Shunsuke Onoe

Authors
  1. Keitaro Sofue
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  2. Masakatsu Tsurusaki
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  3. Takamichi Murakami
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  4. Shunsuke Onoe
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  5. Hiroyuki Tokue
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  6. Kentaro Shibamoto
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  7. Yasuaki Arai
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  8. Kazuro Sugimura
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Corresponding author

Correspondence to Masakatsu Tsurusaki.

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Sofue, K., Tsurusaki, M., Murakami, T. et al. Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?. Eur Radiol 24, 2532–2539 (2014). https://doi.org/10.1007/s00330-014-3233-7

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  • DOI: https://doi.org/10.1007/s00330-014-3233-7

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