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01.10.2014 | Magnetic Resonance

Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?

verfasst von: Keitaro Sofue, Masakatsu Tsurusaki, Takamichi Murakami, Shunsuke Onoe, Hiroyuki Tokue, Kentaro Shibamoto, Yasuaki Arai, Kazuro Sugimura

Erschienen in: European Radiology | Ausgabe 10/2014

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Abstract

Objectives

To compare diagnostic performance in the detection of colorectal liver metastases between 64-detector-row contrast-enhanced CT (CE-CT) alone and the combination of CE-CT and gadoxetic acid-enhanced MRI (EOB-MRI) at 3.0T, and to assess whether EOB-MRI in addition to CE-CT results in a change to initially planned operative strategy.

Methods

A total of 39 patients (27 men, mean age 65 years) with 85 histopathologically confirmed liver metastases were included. At EOB-MRI, unenhanced (T1- and T2-weighted), dynamic, and hepatocyte-phase images were obtained. At CE-CT, four-phase dynamic contrast-enhanced images were obtained. One on-site reader and three off-site readers independently reviewed both CE-CT alone and the combination of CE-CT and EOB-MRI. Sensitivity, positive predictive value, and alternative free-response receiver operating characteristic (AFROC) method were calculated. Differences in therapeutic strategy before and after the EOB-MRI examination were also evaluated.

Results

Sensitivity and area under the AFROC curve with the combination of CE-CT and EOB-MRI were significantly superior to those with CE-CT alone. Changes in surgical therapy were documented in 13 of 39 patients.

Conclusions

The combination of CE-CT and EOB-MRI may provide better diagnostic performance than CE-CT alone for the detection of colorectal liver metastases, and EOB-MRI in addition to CE-CT resulted in changes to the planned operative strategy in one-third of the patients.

Key Points

• Accurate preoperative imaging is essential for surgical planning and successful hepatic resection.

• Combination of CE-CT and EOB-MRI is useful to detect colorectal liver metastases.

• EOB-MRI combined with CE-CT contributes to determine the correct therapeutic strategy.

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Titel: Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?
verfasst von: Keitaro Sofue
Masakatsu Tsurusaki
Takamichi Murakami
Shunsuke Onoe
Hiroyuki Tokue
Kentaro Shibamoto
Yasuaki Arai
Kazuro Sugimura
Publikationsdatum: 01.10.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3233-7

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Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?