title: Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?
abstract: OBJECTIVE
  To compare diagnostic performance in the detection of colorectal liver metastases between 64-detector-row contrast-enhanced CT (CE-CT) alone and the combination of CE-CT and gadoxetic acid-enhanced MRI (EOB-MRI) at 3.0T, and to assess whether EOB-MRI in addition to CE-CT results in a change to initially planned operative strategy.
  
  
  METHODS
  A total of 39 patients (27 men, mean age 65 years) with 85 histopathologically confirmed liver metastases were included. At EOB-MRI, unenhanced (T1- and T2-weighted), dynamic, and hepatocyte-phase images were obtained. At CE-CT, four-phase dynamic contrast-enhanced images were obtained. One on-site reader and three off-site readers independently reviewed both CE-CT alone and the combination of CE-CT and EOB-MRI. Sensitivity, positive predictive value, and alternative free-response receiver operating characteristic (AFROC) method were calculated. Differences in therapeutic strategy before and after the EOB-MRI examination were also evaluated.
  
  
  RESULTS
  Sensitivity and area under the AFROC curve with the combination of CE-CT and EOB-MRI were significantly superior to those with CE-CT alone. Changes in surgical therapy were documented in 13 of 39 patients.
  
  
  CONCLUSIONS
  The combination of CE-CT and EOB-MRI may provide better diagnostic performance than CE-CT alone for the detection of colorectal liver metastases, and EOB-MRI in addition to CE-CT resulted in changes to the planned operative strategy in one-third of the patients.
  
  
  CONCLUSIONS
  • Accurate preoperative imaging is essential for surgical planning and successful hepatic resection. • Combination of CE-CT and EOB-MRI is useful to detect colorectal liver metastases. • EOB-MRI combined with CE-CT contributes to determine the correct therapeutic strategy.
authors.affiliation: Division of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Sofue
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Tsurusaki
authors.forename: Takamichi
authors.initials: T
authors.lastname: Murakami
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Onoe
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tokue
authors.forename: Kentaro
authors.initials: K
authors.lastname: Shibamoto
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Arai
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimura
mesh_terms: D000368:Aged; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy / Q000592:standards; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006498:Hepatectomy; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000379:methods*; D012372:ROC Curve
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA