Small (<or= 2 cm) hepatic lesions in colorectal cancer patients: detection and characterization on mangafodipir trisodium-enhanced MRI.
OBJECTIVE
The purpose of this study was to evaluate whether mangafodipir trisodium (MnDPDP)-enhanced MRI improves the detection and characterization of small (<or= 2 cm) hepatic lesions in patients with colorectal carcinoma, compared with helical CT. SUBJECTS AND METHODS. Sixty-nine patients who had or were suspected of having focal liver lesions underwent helical CT and MnDPDP-enhanced MRI and constituted the study population. Two experienced radiologists independently reviewed CT and MR images for the number of hepatic lesions seen and whether the lesion appeared to be benign or metastatic; their interpretations were correlated with the reference diagnoses, including histopathologic diagnoses in 35 patients. The lesions were categorized as small (<or= 2.0 cm in diameter) or large (> 2.0 cm). The differences between MnDPDP-enhanced MRI and helical CT with regard to the detection rates for hepatic lesions and metastases and with regard to the false-positive rates for hepatic metastases were analyzed using the McNemar test. The performances of MnDPDP-enhanced MRI and helical CT in indicating metastases of focal liver lesions were analyzed using receiver operating characteristic curves.


RESULTS
No statistically significant differences were seen between MnDPDP-enhanced MRI and helical CT in the detection of all hepatic lesions (p = 0.383) and small lesions (p = 0.210). However, concerning the differentiation between benign and metastatic lesions, MnDPDP-enhanced MRI was superior to helical CT both for all hepatic lesions (p = 0.023) and for small lesions (p = 0.015), and remained better when the analyses were restricted to patients with histopathologic confirmation (p = 0.023 for both). MnDPDP-enhanced MRI changed the diagnosis of hepatic metastasis in nine (13.0%) of 69 patients. Of 12 metastases that were found on MnDPDP-enhanced MRI and missed on helical CT, 11 lesions (91.7%) were small. MnDPDP-enhanced MRI showed a significantly greater detection rate than helical CT for small hepatic metastases (p = 0.022). MnDPDP-enhanced MRI was better when the analyses were restricted to patients with histopathologic confirmation (p = 0.043).


CONCLUSIONS
Although MnDPDP-enhanced MRI is equal to helical CT in detection of both all hepatic lesions and small lesions in patients with colorectal carcinoma, it is superior to CT in characterization of the lesions.
Kim
Kyoung Won
KW
Department of Radiology, University of Ulsan-Asan Medical Center, 388-1, Pungnap-dong, Songpa-ku, Seoul 138-736, Korea.
Kim
Ah Young
AY
Kim
Tae Kyoung
TK
Park
Seong Ho
SH
Kim
Hyun Jin
HJ
Lee
Young Kyung
YK
Park
Mi-Suk
MS
Ha
Hyun Kwon
HK
Kim
Pyo Nyun
PN
Kim
Jin Cheon
JC
Lee
Moon-Gyu
MG
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003287:Contrast Media; D004492:Edetic Acid / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011732:Pyridoxal Phosphate / Q000031:analogs & derivatives*; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid