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07.05.2018 | Hepatobiliary-Pancreas

Diagnostic accuracy of CE-CT, MRI and FDG PET/CT for detecting colorectal cancer liver metastases in patients considered eligible for hepatic resection and/or local ablation

verfasst von: Kim Sivesgaard, Lars P. Larsen, Michael Sørensen, Stine Kramer, Sven Schlander, Nerijus Amanavicius, Arindam Bharadwaz, Dennis Tønner Nielsen, Frank Viborg Mortensen, Erik Morre Pedersen

Erschienen in: European Radiology | Ausgabe 11/2018

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Abstract

Purpose

To compare the diagnostic performance of contrast-enhanced computed tomography (CE-CT), magnetic resonance imaging (MRI) and combined fluorodeoxyglucose/positron emission tomography/computed tomography (FDG-PET/CT) for detection of colorectal liver metastases (CRLM) in patients eligible for local treatment.

Materials and methods

This health-research ethics-committee-approved prospective consecutive diagnostic accuracy study, with written informed consent, included 80 cases (76 patients, four participating twice) between 29 June 2015 and 7 February 2017. Prior chemotherapy or local treatment did not exclude participation. Combined FDG-PET/CT including CE-CT and MRI was performed within 0–3 days shortly before local treatment. CE-CT and MRI images were read independently by two readers for each modality. The combined FDG-PET/CT images were read independently by two pairs of readers. A composite reference standard was used. Sensitivities, specificities and area under the receiver operating characteristic curves (AUC_ROC) were calculated and compared.

Results

In total, 260 CRLMs were confirmed. The MRI readers had significantly higher per-lesion sensitivity (85.9% and 83.8%) than both CE-CT readers (69.1% and 62.3%) and both PET/CT reader pairs (72.0% and 72.1%) (p<0.001). There were no significant differences in per-lesion specificity. MRI readers had significantly higher AUC_ROC (0.92 and 0.88) than both CE-CT readers (0.80 and 0.82) (p≤0.001). AUC_ROC for MR reader 1 was higher than that of both PET/CT reader pairs (0.83 and 0.84) (p≤0.0001).

Conclusion

MRI performed significantly better than both CE-CT and combined FDG-PET/CT for detection of CRLM in consecutive patients eligible for local treatment irrespective of prior chemotherapy or local treatment.

Key Points

• Patients eligible for local treatment of colorectal liver-metastases require optimal imaging.

• In 80 consecutive patients, MRI had superior per lesion diagnostic performance.

• Findings were independent of prior treatment and type of planned local treatment.

• Equally, MRI had superior diagnostic performance on per segment basis.

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Titel: Diagnostic accuracy of CE-CT, MRI and FDG PET/CT for detecting colorectal cancer liver metastases in patients considered eligible for hepatic resection and/or local ablation
verfasst von: Kim Sivesgaard
Lars P. Larsen
Michael Sørensen
Stine Kramer
Sven Schlander
Nerijus Amanavicius
Arindam Bharadwaz
Dennis Tønner Nielsen
Frank Viborg Mortensen
Erik Morre Pedersen
Publikationsdatum: 07.05.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 11/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5469-0

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Diagnostic accuracy of CE-CT, MRI and FDG PET/CT for detecting colorectal cancer liver metastases in patients considered eligible for hepatic resection and/or local ablation