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01-10-2012 | Original article

Detection of liver metastasis: is diffusion-weighted imaging needed in Gd-EOB-DTPA-enhanced MR imaging for evaluation of colorectal liver metastases?

Authors: Taku Tajima, Masaaki Akahane, Hidemasa Takao, Hiroyuki Akai, Shigeru Kiryu, Hiroshi Imamura, Yasushi Watanabe, Norihiro Kokudo, Kuni Ohtomo

Published in: Japanese Journal of Radiology | Issue 8/2012

Abstract

Purpose

We compared diagnostic ability for detecting hepatic metastases between gadolinium ethoxy benzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) on a 1.5-T system, and determined whether DWI is necessary in Gd-EOB-DTPA-enhanced MRI for diagnosing colorectal liver metastases.

Materials and methods

We assessed 29 consecutive prospectively enrolled patients with suspected metachronous colorectal liver metastases; all patients underwent surgery and had preoperative Gd-EOB-DTPA-enhanced MRI. Overall detection rate, sensitivity for detecting metastases and benign lesions, positive predictive value, and diagnostic accuracy (Az value) were compared among three image sets [unenhanced MRI (DWI set), Gd-EOB-DTPA-enhanced MRI excluding DWI (EOB set), and combined set].

Results

Gd-EOB-DTPA-enhanced MRI yielded better overall detection rate (77.8–79.0 %) and sensitivity (87.1–89.4 %) for detecting metastases than the DWI set (55.9 % and 64.7 %, respectively) for one observer (P < 0.001). No statistically significant difference was seen between the EOB and combined sets, although several metastases were newly detected on additional DWI.

Conclusions

Gd-EOB-DTPA-enhanced MRI yielded a better overall detection rate and higher sensitivity for detecting metastases compared with unenhanced MRI. Additional DWI may be able to reduce oversight of lesions in Gd-EOB-DTPA-enhanced 1.5-T MRI for detecting colorectal liver metastases.

Liu LX, Zhang WH, Jiang HC. Current treatment for liver metastases from colorectal cancer. World J Gastroenterol. 2003;9(2):193–200.PubMed

Helmberger T, Gregor M, Holzknecht N, Gauger J, Rau H, Reiser MF. Comparison of dual-phase helical CT with native and ferumoxide-enhanced magnetic resonance imaging in detection and characterization of focal liver lesions. Radiology. 1999;39:678–84.CrossRef

Hagspiel KD, Neidl KF, Eichenberger AC, Weder W, Marincek B. Detection of liver metastases: comparison of superparamagnetic iron oxide–enhanced and unenhanced MR imaging at 1.5-T with dynamic CT, intraoperative US, and percutaneous US. Radiology. 1995;196:471–8.PubMed

Semelka RC, Martin DR, Balci C, Lance T. Focal liver lesions: comparison of dual-phase CT and multisequence multiplanar MR imaging including dynamic gadolinium enhancement. J Magn Reson Imaging. 2001;13:397–401.PubMedCrossRef

Ward J, Naik KS, Guthrie JA, Wilson D, Robinson PJ. Hepatic lesion detection: comparison of MR imaging after administration of superparamagnetic iron oxide with dual-phase CT by using alternative-free response receiver operating characteristic analysis. Radiology. 1999;210:459–66.PubMed

Semelka RC, Helmberger TK. Contrast agents for MR imaging of the liver. Radiology. 2001;218:27–38.PubMed

Weinmann HJ, Schuhmann-Giampieri G, Schmitt-Willich H, Vogler H, Frenzel T, Gries H. A new lipophilic gadolinium chelate as a tissue-specific contrast medium for MRI. Magn Reson Med. 1991;22:233–7.PubMedCrossRef

Schuhmann-Giampieri G, Schmitt-Willich H, Press WR, Negishi C, Weinmann HJ, Speck U. Preclinical evaluation of Gd-EOB-DTPA as a contrast agent in MR imaging of the hepatobiliary system. Radiology. 1992;183:59–64.PubMed

Zech CJ, Herrmann KA, Reiser MF, Schoenberg SO. MR imaging in patients with suspected liver metastases: value of liver-specific contrast agent Gd-EOB-DTPA. Magn Reson Med Sci. 2007;6(1):43–52.PubMedCrossRef

10.

Nasu K, Kuroki Y, Nawano S, Kuroki S, Tsukamoto T, Yamamoto S, et al. Hepatic metastases: diffusion-weighted sensitivity-encoding versus SPIO-enhanced MR imaging. Radiology. 2006;239:122–30.PubMedCrossRef

11.

Low RN, Gurney J. Diffusion-weighted MRI (DWI) in the oncology patient: value of breathhold DWI compared to unenhanced and gadolinium-enhanced MRI. J Magn Reson Imaging. 2007;25:848–58.PubMedCrossRef

12.

Ichikawa T, Haradome H, Hachiya J, Nitatori T, Araki T. Diffusion-weighted MR imaging with a single-shot echoplanar sequence: detection and characterization of focal hepatic lesions. AJR Am J Roentgenol. 1998;170:397–402.PubMed

13.

Naganawa S, Sato C, Nakamura T, Kumada H, Ishigaki T, Miura S, et al. Diffusion-weighted images of the liver: comparison of tumor detection before and after contrast enhancement with superparamagnetic iron oxide. J Magn Reson Imaging. 2005;21:836–40.PubMedCrossRef

14.

Chung WS, Kim MJ, Chung YE, Kim YE, Park MS, Choi JY, et al. Comparison of gadoxetic acid-enhanced dynamic imaging and diffusion-weighted imaging for the preoperative evaluation of colorectal liver metastases. J Magn Reson Imaging. 2011;34(2):345–53.PubMedCrossRef

15.

Semelka RC, Brown ED, Ascher SM, Patt RH, Bagley AS, Li W, et al. Hepatic hemangiomas: a multi-institutional study of appearance on T2-weighted and serial gadolinium-enhanced gradient-echo MR images. Radiology. 1994;192:401–6.PubMed

16.

Bartolozzi C, Cioni D, Donati F, Lencioni R. Focal liver lesions: MR imaging pathologic correlation. Eur Radiol. 2001;11:1374–88.PubMedCrossRef

17.

Horton KM, Bluemke DA, Hruban RH, Soyer P, Fishman EK. CT and MR imaging of benign hepatic and biliary tumors. Radiographics. 1999;19:431–51.PubMed

18.

Bennett BM. On comparisons of sensitivity, specificity and predictive value of a number of diagnostic procedures. Biometrics. 1972;28:793–800.PubMedCrossRef

19.

Chakraborty DP, Winter LH. Free-response methodology: alternate analysis and a new observer-performance experiment. Radiology. 1990;174:873–81.PubMed

20.

Kundel HL, Polansky M. Measurement of observer agreement. Radiology. 2003;228:303–8.PubMedCrossRef

21.

Shimada K, Isoda H, Hirokawa Y, Arizono S, Shibata T, Togashi K. Comparison of gadolinium-EOB-DTPA-enhanced and diffusion-weighted liver MRI for detection of small hepatic metastases. Eur Radiol. 2010;20(11):2690–8.PubMedCrossRef

22.

Löwenthal D, Zeile M, Lim WY, Wybranski C, Fischbach F, Wieners G, et al. Detection and characterization of focal liver lesions in colorectal carcinoma patients: comparison of diffusion-weighted and Gd-EOB-DTPA enhanced MR imaging. Eur Radiol. 2011;21:832–40.PubMedCrossRef

23.

Huppertz A, Balzer T, Blakeborough A, Breuer J, Giovagnoni A, Heinz-Peer G, et al. Improved detection of focal liver lesions at MR imaging: multicenter comparison of gadoxetic acid-enhanced MR images with intraoperative findings. Radiology. 2004;230:266–75.PubMedCrossRef

24.

Holzapfel K, Eiber MJ, Fingerle AA, Bruegel M, Rummeny EJ, Gaa J. Detection, classification, and characterization of focal liver lesions: Value of diffusion-weighted MR imaging, gadoxetic acid-enhanced MR imaging and the combination of both methods. Abdom Imaging. 2011 (Epub ahead of print).

25.

Kim YK, Kim CS, Han YM, Lee YH. Detection of liver malignancy with gadoxetic acid-enhanced MRI: is addition of diffusion-weighted MRI beneficial? Clin Radiol. 2011;66(6):489–96.PubMedCrossRef

26.

Motosugi U, Ichikawa T, Onohara K, Sou H, Sano K, Muhi A, et al. Distinguishing hepatic metastasis from hemangioma using gadoxetic acid-enhanced magnetic resonance imaging. Invest Radiol. 2011;46(6):359–65.PubMedCrossRef

27.

Rosenkrantz AB, Oei M, Babb JS, Niver BE, Taouli B. Diffusion-weighted imaging of the abdomen at 3.0 Tesla: image quality and apparent diffusion coefficient reproducibility with 1.5-Tesla. J Magn Reson Imaging. 2011;33(1):128–35.PubMedCrossRef

28.

Uto T, Takehara Y, Nakamura Y, Naito T, Hashimoto D, Inui N, et al. Higher sensitivity and specificity for diffusion-weighted imaging of malignant lung lesions without apparent diffusion coefficient quantification. Radiology. 2009;252(1):247–54.PubMedCrossRef

Title: Detection of liver metastasis: is diffusion-weighted imaging needed in Gd-EOB-DTPA-enhanced MR imaging for evaluation of colorectal liver metastases?
Authors: Taku Tajima
Masaaki Akahane
Hidemasa Takao
Hiroyuki Akai
Shigeru Kiryu
Hiroshi Imamura
Yasushi Watanabe
Norihiro Kokudo
Kuni Ohtomo
Publication date: 01-10-2012
Publisher: Springer Japan
Published in: Japanese Journal of Radiology / Issue 8/2012
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-012-0105-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Detection of liver metastasis: is diffusion-weighted imaging needed in Gd-EOB-DTPA-enhanced MR imaging for evaluation of colorectal liver metastases?

Abstract

Purpose

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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