Disappearing or residual tiny (≤5 mm) colorectal liver metastases after chemotherapy on gadoxetic acid-enhanced liver MRI and diffusion-weighted imaging: Is local treatment required?
To evaluate the clinical course of disappearing colorectal liver metastases (DLM) or residual tiny (≤5 mm) colorectal liver metastases (RTCLM) on gadoxetic acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) in patients who had colorectal liver metastases (CLM) and received chemotherapy.
Among 137 patients who received chemotherapy for CLM and underwent gadoxetic acid-enhanced MRI and DWI between 2010 and 2012, 43 patients with 168 DLMs and 48 RTCLMs were included. The cumulative in situ recurrence rate of DLM and progression rate of RTCLM and their predictive factors were evaluated.
A total of 150 DLMs and 26 RTCLMs were followed up without additional treatment. At 1 and 2 years, respectively, the cumulative in situ recurrence rates for DLM were 10.9 % and 15.7 % and the cumulative progression rates for RTCLM were 27.2 % and 33.2 %. The in situ recurrence rate at 2 years was 4.9 % for the DLM group that did not show reticular hypointensity of liver parenchyma on hepatobiliary phase.
DLM on gadoxetic acid-enhanced liver MRI and DWI indicates a high possibility of clinical complete response, especially in patients without chemotherapy-induced sinusoidal obstruction syndrome. Thirty-three percent of RTCLMs showed progression at 2 years.
• DLMs on gadoxetic acid-enhanced MRI and DWI showed low recurrence rates.
• If there is sinusoidal obstruction syndrome, evaluation of DLM needs special care.
• The progression rate for residual tiny CLMs was 33.2 % at 2 years.
KeywordsColorectal liver metastasis Gadoxetic acid-enhanced MRI Chemotherapy Disappearing metastasis Residual tiny metastasis
Apparent diffusion coefficient
Colorectal liver metastases
Disappearing liver metastases
Magnetic resonance imaging
Residual tiny colorectal liver metastases
The scientific guarantor of this publication is Won Jae Lee, the head of radiology department. 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. The authors state that this work has not received any funding. Kyung A. Kim from the Center for Biostatistics and Clinical Epidemiology (Samsung Medical Center) kindly provided statistical advice for this manuscript. This study was performed on human subjects. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. No study subjects or cohorts have been previously reported. Methodology: retrospective, observational, performed at one institution.
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