title: Comparison of MRI (including SS SE-EPI and SPIO-enhanced MRI) and FDG-PET/CT for the detection of colorectal liver metastases.
abstract: Fluoro-18-deoxyglucose positron emission tomography computed tomography (FDG-PET/CT) and magnetic resonance imaging (MRI), including unenhanced single-shot spin-echo echo planar imaging (SS SE-EPI) and small paramagnetic iron oxide (SPIO) enhancement, were compared prospectively for detecting colorectal liver metastases. Twenty-four consecutive patients suspected for metastases underwent MRI and FDG-PET/CT. Fourteen patients (58%) had previously received chemotherapy, including seven patients whose chemotherapy was still continuing to within 1 month of the PET/CT study. The mean interval between PET/CT and MRI was 10.2+/-5.2 days. Histopathology (n=18) or follow-up imaging (n=6) were used as reference. Seventy-seven metastases were detected. In nine patients, MRI and PET/CT gave concordant results. Sensitivities for unenhanced SS SE-EPI, MRI without SS SE-EPI and FDG-PET/CT were, respectively, 100% (p=9 x 10(-10) vs PET, p=8 x 10(-3) vs MRI without SS SE-EPI), 90% (p=2 x 10(-7) vs PET) and 60%. PET/CT sensitivity dropped significantly with decreasing size, from 100% in lesions larger than 20 mm (identical to MRI), over 54% in lesions between 10 and 20 mm (p=3 x 10(5) versus unenhanced SS SE-EPI), to 32% in lesions under 10 mm (p=6 x 10(-5) versus unenhanced SS SE-EPI). Positive predictive value of PET was 100% (identical to MRI). MRI, particularly unenhanced SS SE-EPI, has good sensitivity and positive predictive value for detecting liver metastases from colorectal carcinoma. Its sensitivity is better than that of FDG-PET/CT, especially for small lesions.
authors.affiliation: Department of Radiology, AZ St.-Jan AV, Ruddershove 10, 8000 Bruges, Belgium. kenneth.coenegrachts@azbrugge.be
authors.forename: Kenneth
authors.initials: K
authors.lastname: Coenegrachts
authors.forename: Frank
authors.initials: F
authors.lastname: De Geeter
authors.forename: Leon
authors.initials: L
authors.lastname: ter Beek
authors.forename: Natascha
authors.initials: N
authors.lastname: Walgraeve
authors.forename: Shandra
authors.initials: S
authors.lastname: Bipat
authors.forename: Jaap
authors.initials: J
authors.lastname: Stoker
authors.forename: Hans
authors.initials: H
authors.lastname: Rigauts
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D003287:Contrast Media / Q000494:pharmacology; D003911:Dextrans; D005260:Female; D005290:Ferric Compounds / Q000494:pharmacology; D052203:Ferrosoferric Oxide; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology; D006801:Humans; D007501:Iron / Q000494:pharmacology; D008099:Liver / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010087:Oxides / Q000494:pharmacology; D049268:Positron-Emission Tomography / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D003911:Dextrans; D005290:Ferric Compounds; D058185:Magnetite Nanoparticles; D010087:Oxides; D019788:Fluorodeoxyglucose F18; C000499:ferric oxide; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide
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