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European Radiology
Published in: European Radiology 7/2019

01-07-2019 | Magnetic Resonance Imaging | Oncology

Late gadolinium MRI enhancement of colorectal liver metastases is associated with overall survival among nonsurgical patients

Authors: Helen M. C. Cheung, Jin K. Kim, John Hudson, Natalie Coburn, Paul J. Karanicolas, Calvin Law, Laurent Milot

Published in: European Radiology | Issue 7/2019

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Abstract

Purpose

To determine if late gadolinium MRI enhancement of colorectal liver metastases (CRCLM) is associated with overall survival among nonsurgical patients.

Materials and methods

This retrospective study was approved by the institutional research ethics board. Late gadolinium enhancement was measured using target tumour enhancement (TTE) in all nonsurgical patients with CRCLM who received a 10-min delayed phase gadobutrol-enhanced liver MRI between March 1, 2006, and August 31, 2014. A total of 122 patients met inclusion/exclusion criteria. Patients were dichotomized into strong and weak TTE. Kaplan-Meier and Cox regression statistics were used to determine whether TTE was associated with overall survival. Noncontributory potential confounding variables (age, sex, number and size of metastases, carcinoembryonic (CEA) level, and presence of extrahepatic disease) were excluded from the final Cox regression model using the backward Wald elimination. Subgroup Kaplan-Meier survival analyses were performed on patients who were chemotherapy-naïve and chemotherapy-treated at the time of MRI.

Results

Strong TTE had increased survival compared with those with weak TTE on Kaplan-Meier analysis (2-year survival: 69.8% vs. 43.5%, p = 0.002). Among 96 patients where data was available for multivariable analysis, weak TTE was associated with death (adjusted hazard ratio 0.25, 95% CI 0.11–0.59, p = 0.002), after adjusting for CEA level. Other potential confounders were noncontributory. Subgroup analyses demonstrated that strong TTE had increased survival compared with those with weak TTE in both the chemotherapy-naïve (p = 0.047) and chemotherapy-treated (p = 0.008) groups.

Conclusion

Strong late gadolinium MRI enhancement of CRCLM is associated with overall survival among nonsurgical patients.

Key Points

• MRI enhancement of colorectal liver metastases is associated with overall survival in nonsurgical patients.
• MRI enhancement of colorectal liver metastases is associated with overall survival in both chemotherapy-naïve and chemotherapy-treated subgroups.
Literature
1.
Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J et al (2013) Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 49(6):1374–1403CrossRefPubMed
2.
American Cancer Society (2018) Cancer Facts & Figures 2018. American Cancer Society, Atlanta
3.
Fakih MG (2015) Metastatic colorectal cancer: current state and future directions. J Clin Oncol 33(16):1809–1824CrossRefPubMed
4.
Wanebo HJ, LeGolvan M, Paty PB et al (2012) Meeting the biologic challenge of colorectal metastases. Clin Exp Metastasis 29(7):821–839CrossRefPubMed
5.
Jones OM, Rees M, John TG, Bygrave S, Plant G (2005) Biopsy of resectable colorectal liver metastases causes tumour dissemination and adversely affects survival after liver resection. Br J Surg 92(9):1165–1168CrossRefPubMed
6.
Gerlinger M, Rowan AJ, Horswell S et al (2012) Intratumor heterogeneity and branched evolution revealed by multiregion sequencing. N Engl J Med 366(10):883–892CrossRefPubMedPubMedCentral
7.
8.
Punt CJ, Koopman M, Vermeulen L (2017) From tumour heterogeneity to advances in precision treatment of colorectal cancer. Nat Rev Clin Oncol 14(4):235–246CrossRefPubMed
9.
10.
Sebagh M, Allard MA, Bosselut N et al (2016) Evidence of intermetastatic heterogeneity for pathological response and genetic mutations within colorectal liver metastases following preoperative chemotherapy. Oncotarget. 7(16):21591–21600CrossRefPubMedPubMedCentral
11.
Watanabe T, Kobunai T, Yamamoto Y et al (2011) Heterogeneity of KRAS status may explain the subset of discordant KRAS status between primary and metastatic colorectal cancer. Dis Colon Rectum. 54(9):1170–1178CrossRefPubMed
12.
Tirkes T, Hollar MA, Tann M, Kohli MD, Akisik F, Sandrasegaran K (2013) Response criteria in oncologic imaging: review of traditional and new criteria. Radiographics. 33(5):1323–1341CrossRefPubMed
13.
Cheung HMC, Karanicolas PJ, Hsieh E et al (2018) Late gadolinium enhancement of colorectal liver metastases post-chemotherapy is associated with tumour fibrosis and overall survival post-hepatectomy. Eur Radiol 28(8):3505–3512CrossRefPubMedPubMedCentral
14.
Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45(2):228–247CrossRefPubMed
15.
Dietrich O, Raya JG, Reeder SB, Reiser MF, Schoenberg SO (2007) Measurement of signal-to-noise ratios in MR images: influence of multichannel coils, parallel imaging, and reconstruction filters. J Magn Reson Imaging 26(2):375–385CrossRefPubMed
16.
17.
Tirumani SH, Kim KW, Nishino M et al (2014) Update on the role of imaging in management of metastatic colorectal cancer. Radiographics 34(7):1908–1928CrossRefPubMed
18.
Poultsides GA, Bao F, Servais EL et al (2012) Pathologic response to preoperative chemotherapy in colorectal liver metastases: fibrosis, not necrosis, predicts outcome. Ann Surg Oncol 19(9):2797–2804CrossRefPubMed
19.
Reddy SK, Parker RJ, Leach JW, Hill MJ, Burgart LJ (2016) Tumor histopathology predicts outcomes after resection of colorectal cancer liver metastases treated with and without pre-operative chemotherapy. J Surg Oncol 113(4):456–462CrossRefPubMed
20.
Dietrich O, Raya JG, Reeder SB, Ingrisch M, Reiser MF, Schoenberg SO (2008) Influence of multichannel combination, parallel imaging and other reconstruction techniques on MRI noise characteristics. Magn Reson Imaging 26(6):754–762CrossRefPubMed
21.
Oshinski JN, Yang Z, Jones JR, Mata JF, French BA (2001) Imaging time after Gd-DTPA injection is critical in using delayed enhancement to determine infarct size accurately with magnetic resonance imaging. Circulation 104(23):2838–2842CrossRefPubMed
22.
Metadata
Title
Late gadolinium MRI enhancement of colorectal liver metastases is associated with overall survival among nonsurgical patients
Authors
Helen M. C. Cheung
Jin K. Kim
John Hudson
Natalie Coburn
Paul J. Karanicolas
Calvin Law
Laurent Milot
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06177-w

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