Advertisement

Japanese Journal of Radiology

, Volume 35, Issue 4, pp 197–205 | Cite as

Comparison of gadoxetic acid-enhanced dynamic MR imaging and contrast-enhanced computed tomography for preoperative evaluation of colorectal liver metastases

  • Nobuyuki Asato
  • Masakatsu TsurusakiEmail author
  • Keitaro Sofue
  • Yoko Hieda
  • Takashi Katsube
  • Kazuhiro Kitajima
  • Takamichi Murakami
Original Article

Abstract

Purpose

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.

Results

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).

Conclusion

EOB-MRI provided higher detectability for liver metastases, especially for smaller-sized lesions, than CE-CT in patients with colorectal carcinoma.

Keywords

Magnetic resonance imaging Multidetector computed tomography Liver Neoplasm metastasis Gadoxetic acid 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

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

Informed consent was obtained from all individual patients included in the study.

References

  1. 1.
    Manfredi S, Lepage C, Hatem C, Coatmeur O, Faivre J, Bouvier A-M. Epidemiology and management of liver metastases from colorectal cancer. Ann Surg. 2006;244:254–9.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Charnsangavej C, Clary B, Fong Y, Grothey A, Pawlik TM, Choti MA. Selection of patients for resection of hepatic colorectal metastases: expert consensus statement. Ann Surg Oncol. 2006;13:1261–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Frankel TL, Gian RK, Jarnagin WR. Preoperative imaging for hepatic resection of colorectal cancer metastasis. J Gastrointest Oncol. 2012;3:11–8.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Pawlik TM, Choti MA. Surgical therapy for colorectal metastases to the liver. J Gastrointest Surg. 2007;11:1057–77.CrossRefPubMedGoogle Scholar
  5. 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
  6. 6.
    Merkle EM, Dale BM, Paulson EK. Abdominal MR imaging at 3T. Magn Reson Imaging Clin N Am. 2006;14:17–26.CrossRefPubMedGoogle Scholar
  7. 7.
    von Falkenhausen MM, Lutterbey G, Morakkabati-Spitz N, Walter O, Gieseke J, Blömer R, et al. High-field-strength MR imaging of the liver at 3.0 T: intraindividual comparative study with MR imaging at 1.5 T. Radiology. 2006;241:156–66.CrossRefGoogle Scholar
  8. 8.
    Merkle EM, Dale BM. Abdominal MRI at 3.0 T: the basics revisited. AJR Am J Roentgenol. 2006;186:1524–32.CrossRefPubMedGoogle Scholar
  9. 9.
    Akisik FM, Sandrasegaran K, Aisen AM, Lin C, Lall C. Abdominal MR imaging at 30 T. Radiographics. 2007;27:1433–44.CrossRefPubMedGoogle Scholar
  10. 10.
    Tsurusaki M, Semelka RC, Zapparoli M, Elias J, Altun E, Pamuklar E, et al. Quantitative and qualitative comparison of 3.0 T and 1.5 T MR imaging of the liver in patients with diffuse parenchymal liver disease. Eur J Radiol. 2009;72:314–20.CrossRefPubMedGoogle Scholar
  11. 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. 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
  13. 13.
    Bluemke DA, Sahani D, Amendola M, Balzer T, Breuer J, Brown JJ, et al. Efficacy and safety of MR imaging with liver-specific contrast agent: U.S. multicenter phase III study. Radiology. 2005;237:89–98.CrossRefPubMedGoogle Scholar
  14. 14.
    Ward J. New MR techniques for the detection of liver metastases. Cancer Imaging. 2006;6:33–42.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Zech CJ, Herrmann KA, Reiser MF, Schoenberg SO. MR imaging in patients with suspected liver metastases: value of liver-specific contrast agent Gd-EOB-DTPA. Magn Reson Med Sci. 2007;6:43–52.CrossRefPubMedGoogle Scholar
  16. 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
  17. 17.
    Hekimoglu K, Ustundag Y, Dusak A, Kalaycioglu B, Besir H, Engin H, et al. Small colorectal liver metastases: detection with SPIO-enhanced MRI in comparison with gadobenate dimeglumine-enhanced MRI and CT imaging. Eur J Radiol. 2011;77:468–72.CrossRefPubMedGoogle Scholar
  18. 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
  19. 19.
    Kim YK, Park G, Kim CS, Yu HC, Han YM. Diagnostic efficacy of gadoxetic acid-enhanced MRI for the detection and characterisation of liver metastases: comparison with multidetector-row CT. Br J Radiol. 2012;85:539–47.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 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. 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
  22. 22.
    Metz CE, Herman BA, Roe CA. Statistical comparison of two ROC-curve estimates obtained from partially-paired datasets. Med Decis Making. 1998;18:110–21.CrossRefPubMedGoogle Scholar
  23. 23.
    Cady B, Stone MD. The role of surgical resection of liver metastases in colorectal carcinoma. Semin Oncol. 1991;18:399–406.PubMedGoogle Scholar
  24. 24.
    Fong Y, Blumgart LH. Hepatic colorectal metastasis: current status of surgical therapy. Oncology (Williston Park). 1998;12:1489–98, 1503.Google Scholar
  25. 25.
    Jaeck D, Bachellier P, Guiguet M, Boudjema K, Vaillant JC, Balladur P, et al. Long-term survival following resection of colorectal hepatic metastases. Association Française de Chirurgie. Br J Surg. 1997;84:977–80.CrossRefPubMedGoogle Scholar
  26. 26.
    Bartolozzi C, Donati F, Cioni D, Procacci C, Morana G, Chiesa A, et al. Detection of colorectal liver metastases: a prospective multicenter trial comparing unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT. Eur Radiol. 2004;14:14–20.CrossRefPubMedGoogle Scholar
  27. 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
  28. 28.
    Niekel MC, Bipat S, Stoker J. Diagnostic imaging of colorectal liver metastases with CT, MR imaging, FDG PET, and/or FDG PET/CT: a meta-analysis of prospective studies including patients who have not previously undergone treatment. Radiology. 2010;257:674–84.CrossRefPubMedGoogle Scholar
  29. 29.
    Bipat S, van Leeuwen MS, Comans EFI, Pijl MEJ, Bossuyt PMM, Zwinderman AH, et al. Colorectal liver metastases: CT, MR imaging, and PET for diagnosis–meta-analysis. Radiology. 2005;237:123–31.CrossRefPubMedGoogle Scholar
  30. 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. 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. 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
  33. 33.
    Kim YK, Lee MW, Lee WJ, Kim SH, Rhim H, Lim JH, et al. Diagnostic accuracy and sensitivity of diffusion-weighted and of gadoxetic acid-enhanced 3-T MR imaging alone or in combination in the detection of small liver metastasis (≤1.5 cm in diameter). Invest Radiol. 2012;47:159–66.PubMedGoogle Scholar
  34. 34.
    Chung W-S, Kim M-J, Chung YE, Kim Y-E, Park M-S, Choi J-Y, et al. Comparison of gadoxetic acid-enhanced dynamic imaging and diffusion-weighted imaging for the preoperative evaluation of colorectal liver metastases. J Magn Reson Imaging. 2011;34:345–53.CrossRefPubMedGoogle Scholar
  35. 35.
    Tajima T, Akahane M, Takao H, Akai H, Kiryu S, Imamura H, et al. Detection of liver metastasis: is diffusion-weighted imaging needed in Gd-EOB-DTPA-enhanced MR imaging for evaluation of colorectal liver metastases? Jpn J Radiol. 2012;30:648–58.CrossRefPubMedGoogle Scholar

Copyright information

© Japan Radiological Society 2017

Authors and Affiliations

  • Nobuyuki Asato
    • 1
  • Masakatsu Tsurusaki
    • 1
    • 2
    Email author
  • Keitaro Sofue
    • 2
    • 3
  • Yoko Hieda
    • 4
  • Takashi Katsube
    • 4
  • Kazuhiro Kitajima
    • 5
  • Takamichi Murakami
    • 1
  1. 1.Department of Radiology, Faculty of MedicineKindai UniversityOsakasayamaJapan
  2. 2.Division of Diagnostic RadiologyNational Cancer CenterTokyoJapan
  3. 3.Department of Diagnostic Radiology, Graduate School of MedicineKobe UniversityKobeJapan
  4. 4.Department of Radiology, School of MedicineShimane UniversityIzumoJapan
  5. 5.Department of Radiology, Faculty of MedicineHyogo Medical CollegeNishinomiyaJapan

Personalised recommendations