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European Radiology

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16.02.2016 | Magnetic Resonance

A meta-analysis of diffusion-weighted and gadoxetic acid-enhanced MR imaging for the detection of liver metastases

verfasst von: Valérie Vilgrain, Maxime Esvan, Maxime Ronot, Aurore Caumont-Prim, Christophe Aubé, Gilles Chatellier

Erschienen in: European Radiology | Ausgabe 12/2016

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Abstract

Objectives

To obtain the diagnostic performance of diffusion-weighted (DW) and gadoxetic-enhanced magnetic resonance (MR) imaging in the detection of liver metastases.

Methods

A comprehensive search (EMBASE, PubMed, Cochrane) was performed to identify relevant articles up to June 2015. Inclusion criteria were: liver metastases, DW-MR imaging and/or gadoxetic acid-enhanced MR imaging, and per-lesion statistics. The reference standard was histopathology, intraoperative observation and/or follow-up. Sources of bias were assessed using the QUADAS-2 tool. A linear mixed-effect regression model was used to obtain sensitivity estimates.

Results

Thirty-nine articles were included (1,989 patients, 3,854 metastases). Sensitivity estimates for DW-MR imaging, gadoxetic acid-enhanced MR imaging and the combined sequence for detecting liver metastases on a per-lesion basis was 87.1 %, 90.6 % and 95.5 %, respectively. Sensitivity estimates by gadoxetic acid-enhanced MR imaging and the combined sequence were significantly better than DW-MR imaging (p = 0.0001 and p < 0.0001, respectively), and the combined MR sequence was significantly more sensitive than gadoxetic acid-enhanced MR imaging (p < 0.0001). Similar results were observed in articles that compared the three techniques simultaneously, with only colorectal liver metastases and in liver metastases smaller than 1 cm.

Conclusions

In patients with liver metastases, combined DW-MR and gadoxetic acid-enhanced MR imaging has the highest sensitivity for detecting liver metastases on a per-lesion basis.

Key Points

• DW-MRI is less sensitive than gadoxetic acid-enhanced MRI for detecting liver metastases

• DW-MRI and gadoxetic acid-enhanced MRI is the best combination

• Same results are observed in colorectal liver metastases

• Same results are observed in liver metastases smaller than 1 cm

• Same results are observed when histopathology alone is the reference standard

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Titel: A meta-analysis of diffusion-weighted and gadoxetic acid-enhanced MR imaging for the detection of liver metastases
verfasst von: Valérie Vilgrain
Maxime Esvan
Maxime Ronot
Aurore Caumont-Prim
Christophe Aubé
Gilles Chatellier
Publikationsdatum: 16.02.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 12/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4250-5

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A meta-analysis of diffusion-weighted and gadoxetic acid-enhanced MR imaging for the detection of liver metastases