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Feasibility of Routine Application of Gadoxetic Acid-Enhanced MRI in Combination with Diffusion-Weighted MRI for the Preoperative Evaluation of Colorectal Liver Metastases

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Gadoxetic acid-enhanced magnetic resonance imaging (MRI) in combination with diffusion-weighted MRI (Gd-EOB-MRI/DWI) has become popular for evaluating colorectal liver metastases (CRLM). This retrospective observational study aimed to determine whether this procedure should be indicated prior to hepatectomy in all patients with CRLM.

Methods

A retrospective survey of relevant data of patients who had undergone hepatectomy for CRLM from 2008 to 2014 was performed. The rates of detection by contrast-enhanced computed tomography (CE-CT) and Gd-EOB-MRI/DWI were evaluated. In addition, relapse-free and overall survivals after primary hepatectomy were compared between patients who had undergone only CE-CT versus those who had undergone both CE-CT and Gd-EOB-MRI/DWI.

Results

In all, 419 pathologically confirmed CRLM were resected in 202 hepatectomies in 177 patients. The sensitivity of detection of CRLM was 77 % for CE-CT and 93 % for Gd-EOB-MRI/DWI (P < 0.01). The sensitivity of detection of 1–5, 6–10, and 11–15 mm CRLM by CE-CT was 9.6 % (5/52), 47 % (26/55), and 76 % (57/75), respectively, whereas that by Gd-EOB-MRI/DWI was 54 % (28/52), 91 % (50/55), and 99 % (74/75), respectively; these differences are significant (P < 0.01 for all three groups). Relapse-free (P = 0.99) and overall survival (P = 0.79) did not differ significantly between 37 patients evaluated preoperatively by only CE-CT and 168 patients evaluated by both CE-CT and Gd-EOB-MRI/DWI.

Conclusion

Gd-EOB-MRI/DWI detects small CRLM (≤15 mm) with higher sensitivity than CE-CT. However, whether Gd-EOB-MRI/DWI should be a routine component of preoperative evaluation remains unclear in terms of survival benefit.

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Acknowledgments

We appreciate Dr. Aya Kuchiba’s valuable assistance with statistical analysis.

Disclosure

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Division of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Tokyo, Japan

    Masahiro Tanaka MD, Yoji Kishi MD, PhD, Minoru Esaki MD, PhD, Satoshi Nara MD, PhD & Kazuaki Shimada MD, PhD

  2. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Masahiro Tanaka MD & Masato Nagino MD, PhD

  3. Division of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan

    Mototaka Miyake MD, PhD

  4. Division of Pathology and Clinical Laboratory, National Cancer Center Hospital, Tokyo, Japan

    Nobuyoshi Hiraoka MD, PhD

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  1. Masahiro Tanaka MD
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  2. Yoji Kishi MD, PhD
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  3. Minoru Esaki MD, PhD
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Correspondence to Yoji Kishi MD, PhD.

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Tanaka, M., Kishi, Y., Esaki, M. et al. Feasibility of Routine Application of Gadoxetic Acid-Enhanced MRI in Combination with Diffusion-Weighted MRI for the Preoperative Evaluation of Colorectal Liver Metastases. Ann Surg Oncol 23, 3991–3998 (2016). https://doi.org/10.1245/s10434-016-5362-5

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  • DOI: https://doi.org/10.1245/s10434-016-5362-5

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