title: Detection and characterisation of focal liver lesions in colorectal carcinoma patients: comparison of diffusion-weighted and Gd-EOB-DTPA enhanced MR imaging.
abstract: OBJECTIVE
  To compare diffusion-weighted imaging (DWI) and Gd-EOB-DTPA-enhanced magnetic resonance (MR) imaging for the detection and characterisation of focal liver lesions (FLLs) in patients with colorectal carcinoma.
  
  
  METHODS
  Seventy-three patients underwent MR imaging including echoplanar DWI (MR-DWI) and dynamic (MR-Dyn) and hepatobiliary phase (MR-Late) Gd-EOB-DTPA-enhanced images. Two blinded readers independently reviewed 5 different image sets using a 5-point confidence scale. Accuracy was assessed by the area (A(z)) under the receiver operating characteristic curve, and sensitivity and specificity were calculated.
  
  
  RESULTS
  A total of 332 FLLs were evaluated. Detection rates were significantly higher for MR-Late images (94.4% for benign and 100% for malignant lesions) compared with MR-DWI (78.3% and 97.5%) and MR-Dyn images (81.5% and 89.9%). Accuracy was 0.82, 0.76 and 0.89 for MR-DWI, MR-Dyn and MR-Late images while sensitivity was 0.98, 0.87 and 0.95, respectively. For characterisation of subcentimetre lesions sensitivity was highest for MR-DWI (0.92). Combined reading of unenhanced and contrast-enhanced images had an identical high accuracy of 0.98.
  
  
  CONCLUSIONS
  Late-phase Gd-EOB-DTPA-enhanced images were superior for the detection of FLLs, while DWIs were most valuable for the identification of particularly small metastases. Combined interpretation of unenhanced images resulted in precise characterisation of FLLs.
authors.affiliation: Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Leipziger Strasse 44, 39120 Magdeburg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Löwenthal
authors.forename: M
authors.initials: M
authors.lastname: Zeile
authors.forename: W Y
authors.initials: WY
authors.lastname: Lim
authors.forename: C
authors.initials: C
authors.lastname: Wybranski
authors.forename: F
authors.initials: F
authors.lastname: Fischbach
authors.forename: G
authors.initials: G
authors.lastname: Wieners
authors.forename: M
authors.initials: M
authors.lastname: Pech
authors.forename: S
authors.initials: S
authors.lastname: Kropf
authors.forename: J
authors.initials: J
authors.lastname: Ricke
authors.forename: O
authors.initials: O
authors.lastname: Dudeck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000473:pathology*; D003287:Contrast Media / Q000494:pharmacology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA / Q000494:pharmacology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012372:ROC Curve; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA