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European Radiology
Published in: European Radiology 11/2018

01-11-2018 | 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

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

Published in: European Radiology | Issue 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 (AUCROC) 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 AUCROC (0.92 and 0.88) than both CE-CT readers (0.80 and 0.82) (p≤0.001). AUCROC 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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Metadata
Title
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
Authors
Kim Sivesgaard
Lars P. Larsen
Michael Sørensen
Stine Kramer
Sven Schlander
Nerijus Amanavicius
Arindam Bharadwaz
Dennis Tønner Nielsen
Frank Viborg Mortensen
Erik Morre Pedersen
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5469-0

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