Diagnosis of colorectal hepatic metastases: Comparison of contrast‐enhanced CT, contrast‐enhanced US, superparamagnetic iron oxide‐enhanced MRI, and gadoxetic acid‐enhanced MRI

Muhi, Ali; Ichikawa, Tomoaki; Motosugi, Utaroh; Sou, Hironobu; Nakajima, Hiroto; Sano, Katsuhiro; Sano, Masaaki; Kato, Satoshi; Kitamura, Takatoshi; Fatima, Zareen; Fukushima, Kimiyo; Iino, Hiroshi; Mori, Yoshiyuki; Fujii, Hideki; Araki, Tsutomu

doi:10.1002/jmri.22613

Cited by 145 publications

(105 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Diagnostic accuracy in patients with hypervascular lesions such as HCC, FNH, adenomas and hypervascular metastases (renal carcinomas, neuroendocrine tumors) may be more affected, since arterial enhancement is a cardinal imaging feature of these lesions, which might be hampered by TSM. Diagnostic accuracy in patients with suspected colorectal liver metastases may not be affected at all, since most sensitive detection of liver metastases relies on the hepatobiliary phase of gadoxetate disodium, which is not affected by TSM [4,19].…”

Section: Directions Of Future Researchmentioning

confidence: 99%

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Well

Weinrich

Adam

et al. 2017

Fortschr Röntgenstr

View full text Add to dashboard Cite

Background Gadoxetate disodium is an intracellular contrast agent for magnetic resonance imaging (MRI) of the liver. Recent publications revealed that injection of gadoxetate disodium can lead to imaging artifacts due to transient severe motion (TSM) in the arterial phase of contrast-enhanced liver MRI. In this review we present and discuss published frequencies of TSM, contrast injection and image acquisition protocols, potential risk factors, and proposed strategies to avoid or minimize the effects of TSM. Method Two reviewers independently searched the PubMed search engine for “transient severe motion artifact” and related terms. Reference lists of retrieved articles were also searched. The two reviewers selected in consensus nine studies that reported both frequencies of TSM and potential risk factors. Study data were extracted by both reviewers, and disagreement was resolved by consensus. Results and Conclusion TSM is caused by impaired breath-hold ability after gadoxetate disodium injection and occurs in 5 – 22 % of patients. The dose of applied contrast agent, repeated exposure to gadoxetate disodium, high BMI and pulmonary disease have been described as potential risk factors for TSM. However, there are only few concordant results on this topic and the pathophysiology of TSM has not been identified. Proposed strategies for the prevention of TSM are slow injection rates and low doses of diluted gadoxetate disodium. Accelerated and free-breathing MRI sequence protocols and breath-hold training may minimize the effects of TSM. Further prospective studies are needed to confirm these strategies and to identify the underlying mechanism of TSM. Key Points Citation Format

show abstract

Section: Directions Of Future Researchmentioning

confidence: 99%

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Well

Weinrich

Adam

et al. 2017

Fortschr Röntgenstr

View full text Add to dashboard Cite

show abstract

Section: Surgical Outcomes Following Sems Placementmentioning

confidence: 99%

“…[30][31][32] In the present study, 3 patients with liver metastasis in whom curative hepatectomy might have been applicable underwent EOB-MRI, 99m Tc-GSA scintigraphy, and an ICG test preoperatively. Among them, 2 patients desired the simultaneous liver resection and were discharged without serious complications.…”

Section: Surgical Outcomes Following Sems Placementmentioning

confidence: 99%

“…In the present study, the pathological diagnosis and systemic evaluation could be performed preoperatively following SEMS placement for all patients with obstructive colon cancer. Moreover, EOB-MRI is known to have higher accuracy for the detection of liver metastasis (especially small nodules) compared to enhanced CT scans, 30 and preoperative 99mTc-GSA scintigraphy and the ICG test have been reported to be useful for planning hepatectomies and the prediction of postoperative liver failure. [30][31][32] In the present study, 3 patients with liver metastasis in whom curative hepatectomy might have been applicable underwent EOB-MRI, 99m Tc-GSA scintigraphy, and an ICG test preoperatively.…”

mentioning

confidence: 99%

“…Moreover, EOB-MRI is known to have higher accuracy for the detection of liver metastasis (especially small nodules) compared to enhanced CT scans, 30 and preoperative 99m…”

mentioning

confidence: 99%

See 2 more Smart Citations

Elective Surgery After Endoscopic Self-Expandable Metallic Stent Placement for Patients With Obstructive Colon Cancer: Preoperative Systemic Evaluation and Management

Matsushima

Adachi

Hamada

et al. 2017

International Surgery

View full text Add to dashboard Cite

One-stage curative surgical resection for obstructive colon cancer is challenging. Selfexpandable metallic stents (SEMSs) are known as an alternative treatment used to avoid emergency operation. We aimed to evaluate the significance of SEMS placement as a bridge to surgery and the surgical outcomes of the elective operation. A consecutive 20 patients with obstructive colon cancer undergoing SEMS placement between June 2014 and February 2016 were included. The technical outcomes of the SEMS placement, surgical procedures, and surgical outcomes were evaluated retrospectively. Among them, 2 patients were treated with a SEMS palliatively, and the others were treated with a SEMS as a bridge to surgery. All SEMS were placed successfully at the first attempt, and there was no SEMS-related complication. Before surgery, all patients could be diagnosed histologically, and they were evaluated systemically including proximal colon or distant metastasis. The median time to operation after SEMS placement was 14 days (range 9-20Corresponding author: Hajime Matsushima, Department of Surgery, Nagasaki Rosai Hospital, 2-12-5 Setogoshi, Sasebo, 857-0134, Japan.Tel.: 81-956-49-219181-956-49- , Fax: 81-956-49-2358 E-mail: h.matsushima.1020@gmail.com Int Surg 2017;102 21 days). Seven of the 18 patients underwent a laparoscopic colectomy without conversion to laparotomy. All patients with stage II or III colon cancer underwent curative surgery, and 2 patients with stage IV colon cancer underwent a one-stage resection of the primary colon cancer and simultaneous liver metastasis after the evaluation of hepatic functional reserve. There was no mortality or SEMS-related complication in the perioperative period. SEMS placement as a bridge to surgery for patients with obstructive colon cancer is safe and effective to provide an adequate amount of time for a preoperative systemic management and evaluation.Key words: Colorectal cancer -Malignant colonic obstruction -Self-expandable metallic stent -Bridge to surgery -Palliation C olorectal cancer is a common malignancy, and more than 1 million cases are diagnosed annually worldwide.1 Although the use of screening programs has spread, 8%-29% of colorectal cancer patients are diagnosed in emergency status due to a large bowel obstruction.2,3 The treatment for obstructive colorectal cancer is still controversial. 4Emergency operations such as Hartman's procedure and colostomy have conventionally been performed for patients with obstructive colorectal cancer, but high mortality and morbidity rates remain for this malignancy. 5,6 There are 2 important problems regarding the preoperative evaluation of obstructive colorectal cancer: synchronous colon cancer and liver metastasis. The incidence of synchronous colon cancers in patients diagnosed with colorectal cancer has been reported to be 2% to 10.7%, 7,8 and synchronous liver metastasis has been identified in 20%-30% of patients with primary colorectal cancers.9,10 The preoperative evaluation of the total colon to the proximal part of the obstru...

show abstract

Randomized multicentre trial of gadoxetic acid-enhanced MRIversusconventional MRI or CT in the staging of colorectal cancer liver metastases

Zech

Korpraphong

Huppertz

et al. 2014

British Journal of Surgery

123

View full text Add to dashboard Cite

BackgroundThis multicentre international randomized trial compared the impact of gadoxetic acid-enhanced magnetic resonance imaging (MRI), MRI with extracellular contrast medium (ECCM-MRI) and contrast-enhanced computed tomography (CE-CT) as a first-line imaging method in patients with suspected colorectal cancer liver metastases (CRCLM).MethodsBetween October 2008 and September 2010, patients with suspected CRCLM were randomized to one of the three imaging modalities. The primary endpoint was the proportion of patients for whom further imaging after initial imaging was required for a confident diagnosis. Secondary variables included confidence in the therapeutic decision, intraoperative deviations from the initial imaging-based surgical plan as a result of additional operative findings, and diagnostic efficacy of the imaging modalities versus intraoperative and pathological extent of the disease.ResultsA total of 360 patients were enrolled. Efficacy was analysed in 342 patients (118, 112 and 112 with gadoxetic acid-enhanced MRI, ECCM-MRI and CE-CT respectively as the initial imaging procedure). Further imaging was required in 0 of 118, 19 (17·0 per cent) of 112 and 44 (39·3 per cent) of 112 patients respectively (P < 0·001). Diagnostic confidence was high or very high in 98·3 per cent of patients for gadoxetic acid-enhanced MRI, 85·7 per cent for ECCM-MRI and 65·2 per cent for CE-CT. Surgical plans were changed during surgery in 28, 32 and 47 per cent of patients in the respective groups.ConclusionThe diagnostic performance of gadoxetic acid-enhanced MRI was better than that of CE-CT and ECCM-MRI as the initial imaging modality. No further imaging was needed in the gadoxetic acid-enhanced MRI group and comparison of diagnostic efficacy parameters demonstrated the diagnostic superiority of gadoxetic acid-enhanced MRI. Registration number: NCT00764621(http://clinicaltrials.gov); EudraCT number: 2008-000583-16 (https://eudract.ema.europa.eu/).

show abstract

Diagnosis of colorectal hepatic metastases: Comparison of contrast‐enhanced CT, contrast‐enhanced US, superparamagnetic iron oxide‐enhanced MRI, and gadoxetic acid‐enhanced MRI

Cited by 145 publications

References 37 publications

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

Elective Surgery After Endoscopic Self-Expandable Metallic Stent Placement for Patients With Obstructive Colon Cancer: Preoperative Systemic Evaluation and Management

Randomized multicentre trial of gadoxetic acid-enhanced MRIversusconventional MRI or CT in the staging of colorectal cancer liver metastases

Contact Info

Product

Resources

About