Comparison of gadoxetic acid-enhanced dynamic MR imaging and contrast-enhanced computed tomography for preoperative evaluation of colorectal liver metastases
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To evaluate the diagnostic efficacy of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) vs. contrast-enhanced computed tomography (CE-CT) in the detection of liver metastasis in colorectal carcinoma patients.
Materials and methods
One-hundred fifty-eight consecutive patients with histopathologically confirmed colorectal carcinoma underwent EOB-MRI and CE-CT; 68 patients had 105 surgically confirmed liver metastases. Diagnostic analyses were performed according to sensitivity and positive predictive value (PPV) for liver metastasis detection in combined arterial- and hepatocyte-phase images vs. CE-CT by three readers blinded to clinical data. Diagnostic accuracy and sensitivity were evaluated using the alternative free-response receiver operating characteristic method.
The overall sensitivity of EOB-MRI (91.4%) was significantly higher than that of CE-CT (80.9%, p < 0.001); the higher sensitivity of EOB-MRI was observed especially in smaller-sized lesions (73.3 vs. 56.0% for lesions ≤1 cm; 91.9 vs. 80.8% for lesions >1 cm and ≤2 cm; 99.2 vs. 95.7% for lesions >2 cm). EOB-MRI showed a significantly greater area under the receiver operating characteristic curve (Az value = 0.970) compared with CE-CT (Az value = 0.899, p < 0.01).
EOB-MRI provided higher detectability for liver metastases, especially for smaller-sized lesions, than CE-CT in patients with colorectal carcinoma.
KeywordsMagnetic resonance imaging Multidetector computed tomography Liver Neoplasm metastasis Gadoxetic acid
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual patients included in the study.
- 5.Hussain SM, Wielopolski PA, Martin DR. Abdominal magnetic resonance imaging at 3.0 T: problem or a promise for the future? Top Magn Reson Imaging. 2005;16:325–35.Google Scholar
- 11.Ramalho M, Herédia V, Tsurusaki M, Altun E, Semelka RC. Quantitative and qualitative comparison of 1.5 and 3.0 tesla MRI in patients with chronic liver diseases. J Magn Reson Imaging. 2009;29:869–79.Google Scholar
- 12.Huppertz A, Haraida S, Kraus A, Zech CJ, Scheidler J, Breuer J, et al. Enhancement of focal liver lesions at gadoxetic acid-enhanced MR imaging: correlation with histopathologic findings and spiral CT—initial observations. Radiology. 2005;234:468–78.Google Scholar
- 16.Hammerstingl R, Huppertz A, Breuer J, Balzer T, Blakeborough A, Carter R, et al. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions. Eur Radiol. 2008;18:457–67.CrossRefPubMedGoogle Scholar
- 18.Muhi A, Ichikawa T, Motosugi U, Sou H, Nakajima H, Sano K, et al. Diagnosis of colorectal hepatic metastases: comparison of contrast-enhanced CT, contrast-enhanced US, superparamagnetic iron oxide-enhanced MRI, and gadoxetic acid-enhanced MRI. J Magn Reson Imaging. 2011;34:326–35.CrossRefPubMedGoogle Scholar
- 20.Scharitzer M, Ba-Ssalamah A, Ringl H, Kölblinger C, Grünberger T, Weber M, et al. Preoperative evaluation of colorectal liver metastases: comparison between gadoxetic acid-enhanced 3.0-T MRI and contrast-enhanced MDCT with histopathological correlation. Eur Radiol. 2013;23:2187–96.CrossRefPubMedGoogle Scholar
- 21.Berger-Kulemann V, Schima W, Baroud S, Koelblinger C, Kaczirek K, Gruenberger T, et al. Gadoxetic acid-enhanced 3.0 T MR imaging versus multidetector-row CT in the detection of colorectal metastases in fatty liver using intraoperative ultrasound and histopathology as a standard of reference. Eur J Surg Oncol. 2012;38:670–6.CrossRefPubMedGoogle Scholar
- 24.Fong Y, Blumgart LH. Hepatic colorectal metastasis: current status of surgical therapy. Oncology (Williston Park). 1998;12:1489–98, 1503.Google Scholar
- 27.Ward J, Naik KS, Guthrie JA, Wilson D, Robinson PJ. Hepatic lesion detection: comparison of MR imaging after the administration of superparamagnetic iron oxide with dual-phase CT by using alternative-free response receiver operating characteristic analysis. Radiology. 1999;210:459–66.CrossRefPubMedGoogle Scholar
- 30.Chen L, Zhang J, Zhang L, Bao J, Liu C, Xia Y, et al. Meta-analysis of gadoxetic acid disodium Gd-EOB-DTPA-enhanced magnetic resonance imaging for the detection of liver metastases. PLoS One. 2012;7:486.Google Scholar
- 31.Sofue K, Tsurusaki M, Murakami T, Onoe S, Tokue H, Shibamoto K, 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. 2014;24:2532–9.Google Scholar
- 32.Kim HJ, Lee SS, Byun JH, Kim JC, Yu CS, Park SH, et al. Incremental value of liver MR imaging in patients with potentially curable colorectal hepatic metastasis detected at CT: a prospective comparison of diffusion-weighted imaging, gadoxetic acid-enhanced MR imaging, and a combination of both MR techniques. Radiology. 2015;274:712–22.CrossRefPubMedGoogle Scholar