Cancer Res Treat.  2018 Jan;50(1):60-70. 10.4143/crt.2016.533.

Magnetic Resonance Imaging for Colorectal Cancer Metastasis to the Liver: Comparative Effectiveness Research for the Choice of Contrast Agents

• Seo N
• Park MS
• Han K
• Lee KH
• Park SH
• Choi GH
• Choi JY
• Chung YE
• Kim MJ

• KMID: 2403475
• DOI: http://doi.org/10.4143/crt.2016.533

Abstract

PURPOSE
This study was conducted to compare the diagnostic performance and early recurrence rate between gadoxetic acid-enhanced magnetic resonance imaging (Gd-EOB-MRI) and magnetic resonance imaging (MRI) with extracellular contrast agent (ECA-MRI) for evaluating hepatic lesions in colorectal cancer.
MATERIALS AND METHODS
Between 2005 and 2010, 418 colorectal cancer patients with both preoperative computed tomography (CT) and liver MRI were retrospectively reviewed. Image analysis was based on initial radiologic reports, and diagnostic performance was assessed based on the area under the receiver operating characteristic curve (AUROC). The early intrahepatic recurrence rate within 6 months was then evaluated.
RESULTS
Overall, 291 and 127 patients underwent Gd-EOB-MRI and ECA-MRI, respectively. The AUROCs were not significantly different between Gd-EOB-MRI (0.990; 95% CI, 0.980 to 0.999) and ECA-MRI (0.985; 95% CI, 0.968 to 1.000; p=0.836). When compared with CT alone, ECA-MRI detected additional 21 lesions in 14 patients (14/127, 11.0%), whereas Gd-EOB-MRI detected 56 lesions in 33 patients (33/291, 11.3%) without a significant difference between two MRI groups (p=0.331). The early recurrence rate in the ECA-MRI (28.6%) was significantly higher than that in the Gd-EOB-MRI (11.6%) for patients who underwent hepatic resection (p=0.031).
CONCLUSION
Gd-EOB-MRI is potentially better than ECA-MRI for decreasing the early intrahepatic recurrence rate, although the two MRI modalities showed comparable diagnostic performance in colorectal cancer patients.

Keyword

Colorectal neoplasms; Liver; Neoplasm metastasis; Magnetic resonance imaging; Recurrence

MeSH Terms

Colorectal Neoplasms*
Comparative Effectiveness Research*
Contrast Media*
Humans
Liver*
Magnetic Resonance Imaging*
Neoplasm Metastasis*
Recurrence
Retrospective Studies
ROC Curve
Contrast Media

Figure

• 

  Fig. 1. Flow of patient enrollment. CT, computed tomography; MRI, magnetic resonance imaging; ECA, extracellular contrast agent; ECA-MRI, magnetic resonance imaging with extracellular contrast agent; Gd-EOB-MRI, gadoxetic acid–enhanced magnetic resonance imaging.

• 

  Fig. 2. Hepatic outcomes in study patients. This figure shows the true hepatic outcomes and methods of lesion confirmation in study patients. Hepatic lesions were confirmed by surgery, biopsy, or follow-up imaging (F/U). ECA-MRI, magnetic resonance imaging with extracellular contrast agent; Gd-EOB-MRI, gadoxetic acid–enhanced magnetic resonance imaging.

Reference

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