Gadoxetic acid-enhanced MRI and diffusion-weighted imaging for the detection of colorectal liver metastases after neoadjuvant chemotherapy

• Published in: European radiology Vol. 25; no. 8; pp. 2428 - 2436
• Main Authors: Yu, Mi Hye, Lee, Jeong Min, Hur, Bo Yun, Kim, Tae-You, Jeong, Seung-Yong, Yi, Nam-Joon, Suh, Kyung-Suk, Han, Joon Koo, Choi, Byung-Ihn
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2015; Springer Nature B.V
• Subjects: Accuracy; Acids; Adult; Aged; Aged, 80 and over; Case-Control Studies; Chemotherapy; Chemotherapy, Adjuvant; Colorectal cancer; Colorectal Neoplasms; Contrast Media; Diagnostic Radiology; Diffusion Magnetic Resonance Imaging - methods; Female; Gadolinium DTPA; Gastrointestinal; Hospitals; Humans; Imaging; Internal Medicine; Interventional Radiology; Liver; Liver Neoplasms - drug therapy; Liver Neoplasms - pathology; Liver Neoplasms - secondary; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Neoadjuvant Therapy; Neuroradiology; Observer Variation; Patients; Radiology; Reference Standards; Retrospective Studies; Sensitivity and Specificity; Surgery; Tomography; Tumors; Ultrasound; Neoadjuvant chemotherapy; Gadoxetic acid; Magnetic resonance imaging; Liver metastasis; Colorectal cancer
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-015-3615-5

Objectives To investigate the diagnostic performance of gadoxetic acid-enhanced MRI including diffusion-weighted imaging (DWI) for the detection of colorectal liver metastases (CRLMs) after neoadjuvant chemotherapy (NAC). Methods Our study population comprised 77 patients with 140 CRLMs who underwent gadoxetic acid-enhanced MRI within 1 month prior to surgery: group A (without NAC, n  = 38) and group B (with NAC, n  = 39). Two radiologists independently assessed all MR images and graded their diagnostic confidence for CRLM on a 5-point scale. Diagnostic accuracy, sensitivity and positive predictive values (PPV) were calculated and compared between the two groups. Results Diagnostic accuracy of gadoxetic acid-enhanced MRI in group B was slightly lower than in group A, but a statistically significant difference was not observed (observer 1: A z , 0.926 in group A, 0.905 in group B; observer 2: A z , 0.944 in group A, 0.885 in group B; p  > 0.05). Sensitivity and PPV of group B were comparable to those of group A (observer 1: sensitivity = 93.5 % vs. 93.6 %, PPV = 95.1 % vs. 86.9 %; observer 2: sensitivity = 96.8 % vs. 91.0 %; PPV = 90.0 % vs. 89.7 %; all p  > 0.05). Conclusions Gadoxetic acid-enhanced MRI including DWI provided good diagnostic performance with high sensitivity (>90 %) for the detection of CRLMs, regardless of the influence of NAC. Key Points • Gadoxetic acid-enhanced MRI including DWI shows high sensitivity for CRLMs. • Chemotherapy does not influence the diagnostic performance of liver MRI for CRLMs. • Gadoxetic acid-enhanced MRI can be used for evaluation of CRLMs after NAC.