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European Radiology
Published in: European Radiology 10/2014

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?

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

Published in: European Radiology | Issue 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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Metadata
Title
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?
Authors
Keitaro Sofue
Masakatsu Tsurusaki
Takamichi Murakami
Shunsuke Onoe
Hiroyuki Tokue
Kentaro Shibamoto
Yasuaki Arai
Kazuro Sugimura
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3233-7

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