Detection of colorectal liver metastases: a prospective multicenter trial comparing unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT.
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.
Bartolozzi
Carlo
C
Department of Radiology, University of Pisa, Via Roma 67, 56100, Pisa, Italy. Bartolozzi@do.med.unipi.it
Donati
Francescamaria
F
Cioni
Dania
D
Procacci
Carlo
C
Morana
Giovanni
G
Chiesa
Antonio
A
Grazioli
Luigi
L
Cittadini
Giorgio
G
Cittadini
Giuseppe
G
Giovagnoni
Andrea
A
Gandini
Giovanni
G
Maass
Jochen
J
Lencioni
Riccardo
R
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D003287:Contrast Media; D004492:Edetic Acid / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D011446:Prospective Studies; D011732:Pyridoxal Phosphate / Q000031:analogs & derivatives*; D011856:Radiographic Image Enhancement; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D036542:Tomography, Spiral Computed / Q000379:methods*
D003287:Contrast Media; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid