title: Detection of colorectal hepatic metastases using MnDPDP MR imaging and diffusion-weighted imaging (DWI) alone and in combination.
abstract: To compare the diagnostic accuracy of MnDPDP MR imaging and diffusion-weighted imaging (DWI), alone and in combination, for detecting colorectal liver metastases in patients with suspected metastatic disease. Thirty-three consecutive patients with suspected colorectal liver metastases underwent MR imaging. Three image sets (MnDPDP, DWI and combined MnDPDP and DWI) were reviewed independently by two observers. Lesions were scored on a five-point scale for malignancy and the areas (Az) under the receiver operating characteristic curves were calculated for each observer and image set. The sensitivity and specificity for lesion detection were calculated for each image set and compared. There were 83 metastases, 49 cysts and 1 haemangioma. Using the combined set resulted in the highest diagnostic accuracy for both observers (Az=0.94 and 0.96), with improved averaged sensitivity of lesion detection compared with the DWI set (p=0.01), and a trend towards improved sensitivity compared with the MnDPDP set (p=0.06). There was no difference in the averaged specificity using any of the three image sets (p>0.5). Combination of MnDPDP MR imaging and DWI resulted in the highest diagnostic accuracy and can increase sensitivity without loss in specificity.
authors.affiliation: Cancer Research UK Clinical Magnetic Resonance Research Group, Institute of Cancer Research, Sutton, UK. dowmukoh@icr.ac.uk
authors.forename: D M
authors.initials: DM
authors.lastname: Koh
authors.forename: G
authors.initials: G
authors.lastname: Brown
authors.forename: A M
authors.initials: AM
authors.lastname: Riddell
authors.forename: E
authors.initials: E
authors.lastname: Scurr
authors.forename: D J
authors.initials: DJ
authors.lastname: Collins
authors.forename: S D
authors.initials: SD
authors.lastname: Allen
authors.forename: I
authors.initials: I
authors.lastname: Chau
authors.forename: D
authors.initials: D
authors.lastname: Cunningham
authors.forename: N M
authors.initials: NM
authors.lastname: deSouza
authors.forename: M O
authors.initials: MO
authors.lastname: Leach
authors.forename: J E
authors.initials: JE
authors.lastname: Husband
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; 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; D015588:Observer Variation; D011446:Prospective Studies; D011732:Pyridoxal Phosphate / Q000031:analogs & derivatives; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D011732:Pyridoxal Phosphate; D004492:Edetic Acid; C060076:N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid