title: Diagnosis of colorectal hepatic metastases: comparison of contrast-enhanced CT, contrast-enhanced US, superparamagnetic iron oxide-enhanced MRI, and gadoxetic acid-enhanced MRI.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of contrast-enhanced computed tomography (CE-CT), contrast-enhanced ultrasonography (CE-US), superparamagnetic iron oxide-enhanced magnetic resonance imaging (SPIO-MRI), and gadoxetic acid-enhanced MRI (Gd-EOB-MRI) in the evaluation of colorectal hepatic metastases.
  
  
  METHODS
  In all, 111 patients with colorectal cancers were enrolled in this study. Of the 112 metastases identified in 46 patients, 31 in 18 patients were confirmed histologically and the remaining 81 in 28 patients were confirmed by follow-up imaging. CE-CT, CE-US, SPIO-MRI, and Gd-EOB-MRI were evaluated. Mean (of three readers, except for CE-US) area under the receiver operating characteristic curve (A(z) ), sensitivities, and positive predictive values (PPV) were calculated. Each value was compared to the others by variance z-test or chi-square test with Bonferroni correction.
  
  
  RESULTS
  For all lesions, mean A(z) and sensitivity of Gd-EOB-MRI (0.992, 95% [56/59]) were significantly greater than those of CE-CT (0.847, 63% [71/112]) and CE-US (0.844, 73% [77/106]). For lesions ≤1 cm, mean A(z) and sensitivity of Gd-EOB-MRI (0.999, 92% [22/24]) were significantly greater than those of CE-CT (0.685, 26% [13/50]) and CE-US (0.7, 41% [18/44]). Mean A(z) (95% CI) of SPIO-MRI for all lesions (0.966 [0.929-0.987]) and lesions ≤ 1 cm (0.961 [0.911-0.988]) were significantly greater than those of CE-CT and CE-US. Mean sensitivity of SPIO-MRI for lesions ≤1 cm (63%, 26/41) was significantly greater than that of CE-CT.
  
  
  CONCLUSIONS
  Gd-EOB-MRI and SPIO-MRI were more accurate than CE-CT and CE-US for evaluation of liver metastasis in patients with colorectal carcinoma.
authors.affiliation: Department of Radiology, University of Yamanashi, Yamanshi, Japan.
authors.forename: Ali
authors.initials: A
authors.lastname: Muhi
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Utaroh
authors.initials: U
authors.lastname: Motosugi
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sou
authors.forename: Hiroto
authors.initials: H
authors.lastname: Nakajima
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Sano
authors.forename: Mika
authors.initials: M
authors.lastname: Sano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kato
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kitamura
authors.forename: Zareen
authors.initials: Z
authors.lastname: Fatima
authors.forename: Kimiyo
authors.initials: K
authors.lastname: Fukushima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iino
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Mori
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Araki
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D005290:Ferric Compounds / Q000494:pharmacology*; D019786:Gadolinium DTPA / Q000494:pharmacology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media; D005290:Ferric Compounds; C073590:gadolinium ethoxybenzyl DTPA; C000499:ferric oxide; D019786:Gadolinium DTPA