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Preoperative evaluation of colorectal liver metastases: comparison between gadoxetic acid-enhanced 3.0-T MRI and contrast-enhanced MDCT with histopathological correlation

  • Hepatobiliary-Pancreas
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Abstract

Objectives

The aim of this prospective study was to compare the diagnostic performance of 64-row MDCT and gadoxetic-acid-enhanced MRI at 3.0 T in patients with colorectal liver metastases in correlation with histopathological findings.

Methods

Lesions detected at MDCT and MRI were interpreted by three blinded readers and compared with histopathological workup as the term of reference. Two subgroups of lesions were additionally evaluated: (1) metastases smaller than 10 mm and (2) lesions in patients with and without steatosis of the liver, assessed histopathologically.

Results

Surgery and histopathological workup revealed 81 colorectal liver metastases in 35 patients and diffuse metastatic involvement in 3 patients. In a lesion-by-lesion analysis, significant sensitivity differences could only be found for reader 1 (P = 0.035) and reader 3 (P = 0.003). For segment-based evaluation, MRI was more sensitive only for reader 3 (P = 0.012). The number of false-positive results ranged from 3 to 12 for MDCT and 8 to 11 for MRI evaluation. In the group of small lesions, the sensitivity differed significantly between both methods (P = 0.003). In patients with hepatic steatosis, MRI showed a trend toward better performance than MDCT, but without statistical performance.

Conclusions

The 3.0-T MRI with liver-specific contrast agents is the preferred investigation in the preoperative setting, especially for the assessment of small colorectal liver metastases.

Key Points

• Potential surgical treatment requires accurate radiological assessment of colorectal liver metastases

• Magnetic resonance imaging with gadoxetic acid is the preferred imaging investigation.

• MRI is better than multidetector CT for detecting small liver metastases.

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Authors and Affiliations

  1. Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    M. Scharitzer, A. Ba-Ssalamah, H. Ringl, C. Kölblinger & M. Weber

  2. Department of Surgery, Medical University of Vienna, Vienna, Austria

    T. Grünberger

  3. Department of Radiology, KH Göttlicher Heiland, KH der Barmherzigen Schwestern and St Josef-Krankenhaus, Vienna, Austria

    W. Schima

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  1. M. Scharitzer
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  2. A. Ba-Ssalamah
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  3. H. Ringl
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  4. C. Kölblinger
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  5. T. Grünberger
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  7. W. Schima
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Correspondence to M. Scharitzer.

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Scharitzer, M., Ba-Ssalamah, A., Ringl, H. 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 23, 2187–2196 (2013). https://doi.org/10.1007/s00330-013-2824-z

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  • DOI: https://doi.org/10.1007/s00330-013-2824-z

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