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Late gadolinium MRI enhancement of colorectal liver metastases is associated with overall survival among nonsurgical patients

  • Helen M. C. CheungEmail author
  • Jin K. Kim
  • John Hudson
  • Natalie Coburn
  • Paul J. Karanicolas
  • Calvin Law
  • Laurent Milot
Oncology
  • 38 Downloads

Abstract

Purpose

To determine if late gadolinium MRI enhancement of colorectal liver metastases (CRCLM) is associated with overall survival among nonsurgical patients.

Materials and methods

This retrospective study was approved by the institutional research ethics board. Late gadolinium enhancement was measured using target tumour enhancement (TTE) in all nonsurgical patients with CRCLM who received a 10-min delayed phase gadobutrol-enhanced liver MRI between March 1, 2006, and August 31, 2014. A total of 122 patients met inclusion/exclusion criteria. Patients were dichotomized into strong and weak TTE. Kaplan-Meier and Cox regression statistics were used to determine whether TTE was associated with overall survival. Noncontributory potential confounding variables (age, sex, number and size of metastases, carcinoembryonic (CEA) level, and presence of extrahepatic disease) were excluded from the final Cox regression model using the backward Wald elimination. Subgroup Kaplan-Meier survival analyses were performed on patients who were chemotherapy-naïve and chemotherapy-treated at the time of MRI.

Results

Strong TTE had increased survival compared with those with weak TTE on Kaplan-Meier analysis (2-year survival: 69.8% vs. 43.5%, p = 0.002). Among 96 patients where data was available for multivariable analysis, weak TTE was associated with death (adjusted hazard ratio 0.25, 95% CI 0.11–0.59, p = 0.002), after adjusting for CEA level. Other potential confounders were noncontributory. Subgroup analyses demonstrated that strong TTE had increased survival compared with those with weak TTE in both the chemotherapy-naïve (p = 0.047) and chemotherapy-treated (p = 0.008) groups.

Conclusion

Strong late gadolinium MRI enhancement of CRCLM is associated with overall survival among nonsurgical patients.

Key Points

• MRI enhancement of colorectal liver metastases is associated with overall survival in nonsurgical patients.

• MRI enhancement of colorectal liver metastases is associated with overall survival in both chemotherapy-naïve and chemotherapy-treated subgroups.

Keywords

Magnetic resonance imaging Contrast media Neoplasm metastasis Colorectal neoplasms Biomarkers, tumour 

Abbreviations and acronyms

CEA

Carcinoembryonic antigen

CNR

Contrast-to-noise ratio

CRCLM

Colorectal liver metastases

MRI

Magnetic resonance imaging

REB

Research ethics board

RECIST 1.1

Response Evaluation Criteria in Solid Tumours 1.1

ROI

Region of interest

SD

Standard deviation

SI

Signal intensity

TTE

Target tumour enhancement

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr. Laurent Milot.

Conflict of interest

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.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• cross-sectional study

• performed at one institution

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Helen M. C. Cheung
    • 1
    Email author
  • Jin K. Kim
    • 1
  • John Hudson
    • 1
  • Natalie Coburn
    • 2
  • Paul J. Karanicolas
    • 2
  • Calvin Law
    • 2
  • Laurent Milot
    • 1
  1. 1.Department of Medical Imaging, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoCanada
  2. 2.Department of Surgery, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoCanada

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