title: Gadoxetic acid-enhanced MRI and diffusion-weighted imaging for the detection of colorectal liver metastases after neoadjuvant chemotherapy.
abstract: OBJECTIVE
  To investigate the diagnostic performance of gadoxetic acid-enhanced MRI including diffusion-weighted imaging (DWI) for the detection of colorectal liver metastases (CRLMs) after neoadjuvant chemotherapy (NAC).
  
  
  METHODS
  Our study population comprised 77 patients with 140 CRLMs who underwent gadoxetic acid-enhanced MRI within 1 month prior to surgery: group A (without NAC, n = 38) and group B (with NAC, n = 39). Two radiologists independently assessed all MR images and graded their diagnostic confidence for CRLM on a 5-point scale. Diagnostic accuracy, sensitivity and positive predictive values (PPV) were calculated and compared between the two groups.
  
  
  RESULTS
  Diagnostic accuracy of gadoxetic acid-enhanced MRI in group B was slightly lower than in group A, but a statistically significant difference was not observed (observer 1: A z, 0.926 in group A, 0.905 in group B; observer 2: A z, 0.944 in group A, 0.885 in group B; p > 0.05). Sensitivity and PPV of group B were comparable to those of group A (observer 1: sensitivity = 93.5 % vs. 93.6 %, PPV = 95.1 % vs. 86.9 %; observer 2: sensitivity = 96.8 % vs. 91.0 %; PPV = 90.0 % vs. 89.7 %; all p > 0.05).
  
  
  CONCLUSIONS
  Gadoxetic acid-enhanced MRI including DWI provided good diagnostic performance with high sensitivity (>90 %) for the detection of CRLMs, regardless of the influence of NAC.
  
  
  CONCLUSIONS
  • Gadoxetic acid-enhanced MRI including DWI shows high sensitivity for CRLMs. • Chemotherapy does not influence the diagnostic performance of liver MRI for CRLMs. • Gadoxetic acid-enhanced MRI can be used for evaluation of CRLMs after NAC.
authors.affiliation: Department of Radiology, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Mi Hye
authors.initials: MH
authors.lastname: Yu
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Bo Yun
authors.initials: BY
authors.lastname: Hur
authors.forename: Tae-You
authors.initials: TY
authors.lastname: Kim
authors.forename: Seung-Yong
authors.initials: SY
authors.lastname: Jeong
authors.forename: Nam-Joon
authors.initials: NJ
authors.lastname: Yi
authors.forename: Kyung-Suk
authors.initials: KS
authors.lastname: Suh
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Han
authors.forename: Byung-Ihn
authors.initials: BI
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000556:secondary; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D015588:Observer Variation; D012015:Reference Standards; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA