Korean J Radiol.  2004 Dec;5(4):225-230. 10.3348/kjr.2004.5.4.225.

Follow-up Results After Negative Findings on Unenhanced Hepatic MR Imaging for Hepatic Metastasis from Rectal Cancer

• Lim JS
• Kim MJ
• Lee KY
• Kim NK
• Choi JS
• Kim JH
• Oh YT
• Kim WH
• Kim KW

• KMID: 1118829
• DOI: http://doi.org/10.3348/kjr.2004.5.4.225

Abstract

OBJECTIVE
To assess the follow-up results after negative findings on unenhanced hepatic MR imaging in rectal cancer patients who have undergone locally curative surgery. MATERIALS AND METHODS: From all pertinent imaging reports and medical records, we selected 255 patients who had negative results on unenhanced hepatic MR imaging. When selecting patients who had undergone curative resection, the following patients were excluded from the study: 1) patients in whom extrahepatic metastases were detected on preoperative staging work-ups, 2) patients in whom the surgery was judged to be non-curative due to peritoneal seeding or local aggressiveness. Cases with follow-up periods of less than 18 months were also excluded, as these cases were considered insufficient to confirm the negative outcomes. Thus, a total of 149 patients were ultimately enrolled in our study. The follow-up results of unenhanced MR imagings were assessed according to the assumption that the newly developed hepatic metastases had been false-negative lesions on preoperative MR image. RESULTS: During a median follow-up period of 29.3 months, 25 hepatic metastases were detected in 13 patients (8.7%), which indicated a negative predictive value of 91.3%. CONCLUSION: Unenhanced hepatic MR imaging provides a high negative predictive value with regard to the detection of hepatic metastasis in the preoperative evaluation of rectal cancer.

Keyword

Liver neoplasms, CT; Liver neoplasms, MR; Liver neoplasms, metastases; Rectum, neoplasms

MeSH Terms

Adenocarcinoma/*diagnosis/radiography/*secondary/surgery
Adult
Aged
Aged, 80 and over
Carcinoembryonic Antigen/blood
Digestive System Surgical Procedures
False Negative Reactions
Female
Follow-Up Studies
Humans
Liver Neoplasms/*diagnosis/radiography/*secondary/surgery
*Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Neoplasm Staging
Predictive Value of Tests
Rectal Neoplasms/*pathology
Retrospective Studies
Survival Analysis
*Tomography, X-Ray Computed
Treatment Outcome
Tumor Markers, Biological/blood

Figure

• 

  Fig. 1 A 43 year-old-woman with rectal cancer. A, B. Preoperative MR images (T2-weighted single shot fast spin-echo image [17020/100] (A) and T1-weighted GRE image [230/4.0, 90° flip angle] (B)) show no evidence of metastasis in the liver. C. Low attenuating subcentimetric lesion (white arrow) can be seen in the lateral segment on the follow-up CT scan, obtained three months postoperatively. D. Growth of the lesion on the lateral segment (white arrow) can be seen on the CT scan at eight months postoperatively, which represents a metastasis.

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