title: Efficacy of SPIO-MR imaging in the diagnosis of liver metastases from colorectal carcinomas.
abstract: OBJECTIVE
  To determine whether superparamagnetic iron oxide-enhanced magnetic resonance imaging (SPIO-MRI) could replace intravenous contrast-enhanced spiral CT (iv-CT) and spiral CT during arterial portography (CTAP) combined with spiral CT hepatic angiography (CTHA) in the diagnosis of liver metastases from colorectal carcinomas.
  
  
  METHODS
  Twenty-six adult patients with liver metastases were studied preoperatively by means of iv-CT, CTAP/CTHA, and SPIO-MRI. Preoperative diagnoses using iv-CT, CTAP/CTHA, and SPIO-MRI were compared with intraoperative and pathological findings in resected specimens. The gold standard for the lesions that were resected was histological examination. Intraoperative findings represented the gold standard for lesions that were not resected.
  
  
  RESULTS
  Twenty-six patients were found to have a total number of 43 liver metastases. The sensitivities of iv-CT, CTAP/CTHA, and SPIO-MRI were 74.4, 100, and 90.7%, respectively. SPIO-MRI was significantly superior to iv-CT (p < 0.05). The positive predictive values of iv-CT, CTAP/CTHA, and SPIO-MRI were 97.0, 91.5, and 100%, respectively. CTAP/CTHA yielded four false-positive lesions. In contrast, we detected no false-positive findings using SPIO-MRI.
  
  
  CONCLUSIONS
  These results suggest that SPIO-MRI might not completely replace CTAP/CTHA, but could replace iv-CT in the diagnosis of liver metastases from colorectal carcinomas. It is thought that SPIO-MRI is a promising imaging modality for diagnosing liver metastases in patients with colorectal carcinoma because of its relatively high sensitivity and extremely high specificity.
authors.affiliation: 1st Department of Surgery, Sapporo Medical University, Sapporo, Japan. furuhata@sapmed.ac.jp
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Furuhata
authors.forename: Kenji
authors.initials: K
authors.lastname: Okita
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Tsuruma
authors.forename: Fumitake
authors.initials: F
authors.lastname: Hata
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Kimura
authors.forename: Tadashi
authors.initials: T
authors.lastname: Katsuramaki
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Mukaiya
authors.forename: Naoki
authors.initials: N
authors.lastname: Hirokawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ichimura
authors.forename: Naoya
authors.initials: N
authors.lastname: Yama
authors.forename: Kazumitsu
authors.initials: K
authors.lastname: Koito
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Sasaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011172:Portography / Q000379:methods; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods; D016896:Treatment Outcome