Diagnosis of liver metastases from colorectal adenocarcinoma. Comparison of spiral-CTAP combined with intravenous contrast-enhanced spiral-CT and SPIO-enhanced MR combined with plain MR imaging.
OBJECTIVE
The purpose of this study was to determine whether MR with and without SPIO (AMI-25) could replace spiral-CTAP in the staging of colorectal adenocarcinoma.


METHODS
Thirty-five patients were studied prospectively by means of i.v. contrast-enhanced spiral-CT, spiral-CTAP, and MR of the liver. MR imaging was performed before and after infusion of AMI-25. Diagnoses were compared to intraoperative findings (n = 35) which included intraoperative ultrasound (n = 21), and follow-up CT (n = 18).


CONCLUSIONS
Fifteen patients were found to have a total number of 53 liver metastases and 43 benign lesions were detected. Evaluation was performed in four different ways: 1) i.v. contrast-enhanced spiral-CT; 2) i.v. contrast-enhanced spiral-CT + spiral-CTAP; 3) plain MR; 4) plain MR + SPIO-enhanced MR. I.v. contrast-enhanced spiral-CT, spiral-CTAP and SPIO-enhanced MR identified patients with liver metastases with equal sensitivity. However, owing to its significantly higher sensitivity, based on a lesion-by-lesion analysis, spiral-CTAP cannot be replaced by SPIO-enhanced MR in patients who are to undergo liver resection. A limitation in spiral-CTAP is its relatively low specificity.
Strotzer
M
M
Department of Diagnostic Radiology, University Hospital, Regensburg, Germany.
Gmeinwieser
J
J
Schmidt
J
J
Fellner
C
C
Seitz
J
J
Albrich
H
H
Zirngibl
H
H
Feuerbach
S
S
D000230:Adenocarcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000473:pathology*; D003287:Contrast Media; D003911:Dextrans; D005260:Female; D052203:Ferrosoferric Oxide; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007262:Infusions, Intravenous; D007430:Intraoperative Care; D007501:Iron; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D011172:Portography / Q000379:methods*; D011446:Prospective Studies; D011856:Radiographic Image Enhancement / Q000379:methods; D012004:Rectal Neoplasms / Q000473:pathology*; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013535:Suspensions; D014057:Tomography, X-Ray Computed / Q000379:methods*; D018084:Ultrasonography, Interventional
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D013535:Suspensions; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide