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Characteristics of false-positive lesions in evaluating colorectal liver metastases on gadoxetic acid-enhanced magnetic resonance imaging

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Abstract

Purpose

Gadoxetic acid-enhanced MRI (Gd-EOB-MRI) shows higher sensitivity for colorectal liver metastases (CRLM) than contrast-enhanced computed tomography (CECT). However, the details of false-positive lesions for each imaging modality are unknown.

Methods

Cases undergoing hepatectomy for CRLM following a preoperative evaluation with both CECT and Gd-EOB-MRI between July 2008 and December 2016 were reviewed. The false-positive and false-negative rates were assessed for each modality, and the characteristics of false-positive lesions were evaluated.

Results

We evaluated 275 partial hepatectomies in 242 patients without preoperative chemotherapy. Among the 275 hepatectomies, 546 lesions were recognized by CECT and/or Gd-EOB-MRI. The false-positive rates for CECT and Gd-EOB-MRI were 4% (18/422) and 7% (37/536), respectively. The size of false-positive lesions was significantly smaller than that of correctly diagnosed lesions (median: 28 mm [3–120 mm] vs 7.6 mm [320 mm], P  < 0.001). Compared with the 233 correctly diagnosed lesions ≤ 20 mm in diameter, false-positive lesions were more frequently located near the liver surface or vasculobiliary structures than true lesions (33/37 [89%] vs 149/233 [64%], respectively; P  = 0.0021).

Conclusion

Gd-EOB-MRI had a 7% false-positive rate. A small size and tumor location near the surface or near vasculobiliary structures were associated with false positivity.

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Acknowledgements

We thank LC, MD, MA, and JC, DVM, from Edanz (https://jp.edanz.com/ac) for editing drafts of this manuscript and AK from the Division of Biostatistics, National Cancer Center, Japan, for giving advice regarding the statistical analyses.

Funding

This work was supported by the Practical Research for Innovative Cancer Control (No. 16ck0106211s0101) from the Japan Agency for Medical Research and Development (AMED).

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Authors and Affiliations

  1. Division of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Shuhei Yamada, Yoji Kishi, Satoshi Nara, Minoru Esaki & Kazuaki Shimada

  2. Division of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan

    Yoji Kishi

  3. Division of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Mototaka Miyake

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  1. Shuhei Yamada
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  2. Yoji Kishi
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Correspondence to Yoji Kishi.

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Yamada, S., Kishi, Y., Miyake, M. et al. Characteristics of false-positive lesions in evaluating colorectal liver metastases on gadoxetic acid-enhanced magnetic resonance imaging. Surg Today 52, 1178–1184 (2022). https://doi.org/10.1007/s00595-022-02451-5

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  • DOI: https://doi.org/10.1007/s00595-022-02451-5

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