Detection of colorectal liver metastases: a prospective multicenter trial comparing unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT

Abstract

The aim of this study was to compare unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT in the detection of hepatic colorectal metastases. Forty-four patients with hepatic colorectal metastases were examined with unenhanced and MnDPDP-enhanced MRI and with unenhanced and contrast-enhanced spiral CT. The MR examination protocol included baseline T1-weighted spin-echo (SE), T1-weighted gradient-recalled-echo (GRE), and T2-weighted fast-SE sequences; and T1-weighted SE and T1-weighted GRE sequences obtained 30-60 min after administration of 0.5 micromol/kg (0.5 ml/kg) mangafodipir trisodium (MnDPDP). Images were interpreted by three blinded readers. Findings at CT and MRI were compared with those at intraoperative US, which were used as term of reference. Intraoperative US detected 128 metastases. In a lesion-by-lesion analysis, the overall detection rate was 71% (91 of 128) for spiral CT, 72% (92 of 128) for unenhanced MRI, and 90% (115 of 128) for MnDPDP-enhanced MRI. MnDPDP-enhanced MRI was more sensitive than either unenhanced MRI ( p<0.0001) or spiral CT ( p=0.0007). In a patient-by-patient analysis, agreement with gold standard was higher for MnDPDP-enhanced MRI (33 of 44 cases) than for spiral CT (22 of 44 cases, p=0.0023) and unenhanced MRI (21 of 44 cases, p=0.0013). MnDPDP-enhanced MRI is superior to unenhanced MRI and spiral CT in the detection of hepatic colorectal metastases.

Evaluation of quantitative contrast harmonic imaging to assess malignancy of liver tumors: A prospective controlled two-center study

“…with the introduction of second-generation contrast agents and the use of low MI techniques, such as pulse inversion, which allows a continuous sweep with the same bubbles [1][2][3][5][6][7][8][9][10] . The support of gray-scale images is essential to delineate the lesions better and to check the perfect matching of contrast-enhanced and B-mode images.…”

“…High-resolution digital contrast-enhanced ultrasound techniques have considerably improved the assessment of malignant and benign tumor lesions in the liver [1][2][3][4][5][6][7][8][9][10][11][12] . Under optimal examination conditions that enable imaging of the entire liver, it is possible to attain a diagnostic reliability comparable to that of contrast-enhanced MRI with a liverspecific contrast agent, and an even higher diagnostic certainty of > 90%, compared with contrast-enhanced multi-detector-spiral CT [1,4,15] .…”

“…Since no www.wjgnet.com single diagnostic tool has been able to clarify this question with sufficient reliability up to now, histological analysis remains the gold standard. Characterization of focal hepatic lesions with imaging techniques is an important part of radiological diagnosis and is still the focus of scientific research because of technical innovations of existing methods [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] . Special attention has been paid to the validation of new methods, especially the further development of contrast-enhanced ultrasound techniques because ultrasound is the most common and best available imaging technique [1][2][3][5][6][7][8][9][10][11][12][13][14] .…”

Review article liver metastases

“…10, 11). Compared to helical CT multiple studies have shown that MRI with different contrast agents is superior regarding lesion detection and characterization (31,32). MRI is routinely used in patients with unequivocal CT scans or with contraindications to a CT examination.…”

Kolorektale Lebermetastasen

“…In der Darstellung der Gefäßanatomie der Leber, die für eine Operationsplanung essenziell ist, ist die CT anderen Verfahren überlegen, hinsichtlich Detektion und Charakterisierung fokaler Läsionen jedoch die kontrastmittelverstärkte MRT [31][32][33][34][35][36][37].…”