Advertisement

European Radiology

, 18:903 | Cite as

Detection of colorectal hepatic metastases using MnDPDP MR imaging and diffusion-weighted imaging (DWI) alone and in combination

  • D. M. KohEmail author
  • G. Brown
  • A. M. Riddell
  • E. Scurr
  • D. J. Collins
  • S. D. Allen
  • I. Chau
  • D. Cunningham
  • N. M. deSouza
  • M. O. Leach
  • J. E. Husband
Hepatobiliary-Pancreas

Abstract

To compare the diagnostic accuracy of MnDPDP MR imaging and diffusion-weighted imaging (DWI), alone and in combination, for detecting colorectal liver metastases in patients with suspected metastatic disease. Thirty-three consecutive patients with suspected colorectal liver metastases underwent MR imaging. Three image sets (MnDPDP, DWI and combined MnDPDP and DWI) were reviewed independently by two observers. Lesions were scored on a five-point scale for malignancy and the areas (Az) under the receiver operating characteristic curves were calculated for each observer and image set. The sensitivity and specificity for lesion detection were calculated for each image set and compared. There were 83 metastases, 49 cysts and 1 haemangioma. Using the combined set resulted in the highest diagnostic accuracy for both observers (Az = 0.94 and 0.96), with improved averaged sensitivity of lesion detection compared with the DWI set (p = 0.01), and a trend towards improved sensitivity compared with the MnDPDP set (p = 0.06). There was no difference in the averaged specificity using any of the three image sets (p > 0.5). Combination of MnDPDP MR imaging and DWI resulted in the highest diagnostic accuracy and can increase sensitivity without loss in specificity.

Keywords

Liver Metastases Diffusion-weighted imaging MR imaging Colorectal 

Notes

Acknowledgements

This research was supported by Cancer Research UK Grant C1060/A808.

References

  1. 1.
    Yamada H, Katoh H, Kondo S, Okushiba S, Morikawa T (2001) Repeat hepatectomy for recurrent hepatic metastases from colorectal cancer. Hepatogastroenterology 48:828–830PubMedGoogle Scholar
  2. 2.
    Bolton JS, Fuhrman GM (2000) Survival after resection of multiple bilobar hepatic metastases from colorectal carcinoma. Ann Surg 231:743–751PubMedCrossRefGoogle Scholar
  3. 3.
    Brand MI, Saclarides TJ, Dobson HD, Millikan KW (2000) Liver resection for colorectal cancer: liver metastases in the aged. Am Surg 66:412–415; discussion 415–416Google Scholar
  4. 4.
    Scheele J, Stang R, Altendorf-Hofmann A, Paul M (1995) Resection of colorectal liver metastases. World J Surg 19:59–71PubMedCrossRefGoogle Scholar
  5. 5.
    Masi G, Cupini S, Marcucci L, Cerri E, Loupakis F, Allegrini G, Brunetti IM, Pfanner E, Viti M, Goletti O, Filipponi F, Falcone A (2006) Treatment with 5-fluorouracil/folinic acid, oxaloplatin, and irinotecan enables surgical resection of metastases in patients with initially unresectable metastatic colorectal cancer. Ann Surg Oncol 13:58–65PubMedCrossRefGoogle Scholar
  6. 6.
    Koh DM, Brown G, Meer Z, Norman AR, Husband JE (2007) Diagnostic accuracy of rim and segmental MRI enhancement of colorectal hepatic metastasis after administration of mangafodipir trisodium. AJR Am J Roentgenol 188:W154–161PubMedCrossRefGoogle Scholar
  7. 7.
    Bartolozzi C, Donati F, Cioni D et al (2004) Detection of colorectal liver metastases: a prospective multicenter trial comparing unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT. Eur Radiol 14:14–20PubMedCrossRefGoogle Scholar
  8. 8.
    Nasu K, Kuroki Y, Nawano S et al (2006) Hepatic metastases: diffusion-weighted sensitivity-encoding versus SPIO-enhanced MR imaging. Radiology 239:122–130PubMedCrossRefGoogle Scholar
  9. 9.
    Bipat S, van Leeuwen MS, Comans EF et al (2005) Colorectal liver metastases: CT, MR imaging, and PET for diagnosis-meta-analysis. Radiology 237:123–131PubMedCrossRefGoogle Scholar
  10. 10.
    Yang M, Martin DR, Karabulut N, Frick MP (2003) Comparison of MR and PET imaging for the evaluation of liver metastases. J Magn Reson Imaging 17:343–349PubMedCrossRefGoogle Scholar
  11. 11.
    Ward J, Robinson PJ, Guthrie JA et al (2005) Liver metastases in candidates for hepatic resection: comparison of helical CT and gadolinium- and SPIO-enhanced MR imaging. Radiology 237:170–180PubMedCrossRefGoogle Scholar
  12. 12.
    Choi JY, Kim MJ, Kim JH et al (2006) Detection of hepatic metastasis: manganese- and ferucarbotran-enhanced MR imaging. Eur J Radiol 60:84–90PubMedCrossRefGoogle Scholar
  13. 13.
    Beziat C, Pilleul F, Yzebe D, Lombard-Bohas C, Mercier C, Valette PJ (2004) [Detection of liver metastases in colorectal cancer on chemotherapy. Comparative study between MRI with teslascan and computed tomography with intravenous contrast media]. J Radiol 85:307–311PubMedCrossRefGoogle Scholar
  14. 14.
    Grimm J, Muller-Hulsbeck S, Blume J, Biederer J, Heller M (2001) [Comparison of biphasic spiral CT and MnDPDP-enhanced MRI in the detection and characterization of liver lesions]. Rofo 173:266–272PubMedGoogle Scholar
  15. 15.
    Kim KW, Kim AY, Kim TK et al (2004) Small (<or= 2 cm) hepatic lesions in colorectal cancer patients: detection and characterization on mangafodipir trisodium-enhanced MRI. AJR Am J Roentgenol 182:1233–1240PubMedGoogle Scholar
  16. 16.
    Kane PA, Ayton V, Walters HL et al (1997) MnDPDP-enhanced MR imaging of the liver. Correlation with surgical findings. Acta Radiol 38:650–654PubMedCrossRefGoogle Scholar
  17. 17.
    Koh DM, Collins DJ (2007) Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol 188:1622–1635PubMedCrossRefGoogle Scholar
  18. 18.
    Kiryu S, Watanabe M, Kabasawa H, Akahane M, Aoki S, Ohtomo K (2006) Evaluation of super paramagnetic iron oxide-enhanced diffusion-weighted PROPELLER T2-fast spin echo magnetic resonance imaging: Preliminary experience. J Comput Assist Tomogr 30:197–200PubMedCrossRefGoogle Scholar

Copyright information

© European Society of Radiology 2007

Authors and Affiliations

  • D. M. Koh
    • 1
    • 2
    Email author
  • G. Brown
    • 2
  • A. M. Riddell
    • 2
  • E. Scurr
    • 2
  • D. J. Collins
    • 1
  • S. D. Allen
    • 2
  • I. Chau
    • 3
  • D. Cunningham
    • 3
  • N. M. deSouza
    • 1
  • M. O. Leach
    • 1
  • J. E. Husband
    • 2
  1. 1.Cancer Research UK Clinical Magnetic Resonance Research GroupInstitute of Cancer ResearchSuttonUK
  2. 2.Academic Department of RadiologyRoyal Marsden HospitalSuttonUK
  3. 3.Department of Medical OncologyRoyal Marsden HospitalSuttonUK

Personalised recommendations