Use of Imaging to Predict Complete Response of Colorectal Liver Metastases after Chemotherapy: MR Imaging versus CT Imaging.
Purpose To compare the diagnostic performances of contrast agent-enhanced computed tomography (CT) and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced liver magnetic resonance (MR) imaging (referred to as EOB MR imaging) in the evaluation of disappearing colorectal liver metastases (CRLMs) after chemotherapy. Materials and Methods The eight institutional review boards approved this retrospective study and waived the requirement for informed consent. On the basis of retrospective searches in eight hospitals, 87 patients with 393 CRLMs, each patient with one or more CRLM that later disappeared on contrast-enhanced CT scans after chemotherapy, and subsequently underwent surgery for the CRLMs, were enrolled. The anonymized imaging data and case report forms were sent to the central review system and independently reviewed by four radiologists. All anonymized data were randomly allocated into two groups (groups A and B), which were read by two independent readers. True absence of tumor was defined as pathologic absence of tumor for resected lesions and no in situ recurrence within 1 year after surgery for lesions left unresected at each 3-month follow-up contrast-enhanced CT. Positive predictive values for absence of tumor and for residual tumor on contrast-enhanced CT and EOB MR images were compared by using a generalized estimating equation. Results Among 393 CRLMs, the positive predictive value for absence of tumor on EOB MR images (78.0%; 95% confidence interval [CI]: 63.68%, 87.74%) was significantly higher than that on contrast-enhanced CT scans (35.2%; 95% CI: 25.11%, 46.79%; P < .001). The positive predictive value for residual tumor on CT scans (86.0%; 95% CI: 78.61%, 91.16%) was higher than that on EOB MR images (83.8%; 95% CI: 77.50%, 88.67%) without statistical significance (P = .330). Conclusion EOB MR imaging was superior to contrast-enhanced CT imaging for assessment of disappearing CRLMs after chemotherapy.©RSNA, 2017 Online supplemental material is available for this article.
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Min Jung
MJ
Park
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Nurhee
N
Hong
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Kyunghwa
K
Han
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Min Ju
MJ
Kim
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Yoon Jin
YJ
Lee
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Yang Shin
YS
Park
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Sung Eun
SE
Rha
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Sumi
S
Park
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Won Jae
WJ
Lee
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Seong Ho
SH
Park
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Chang Hee
CH
Lee
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Chung Mo
CM
Nam
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Chansik
C
An
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Hye Jin
HJ
Kim
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Honsoul
H
Kim
From the Departments of Radiology (M.J.P., K.H., C.A., H.J.K., H.K., M.S.P.) and Biostatistics (K.H., C.M.N.), Yonsei University College of Medicine, Severance Hospital, 50 Yonsei-Ro, Seodaemun-Gu, Seoul 120-752, Korea; Department of Radiology, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea (N.H., S.H.P.); Center for Colorectal Cancer, National Cancer Center, Ilsan, Korea (M.J.K.); Department of Radiology, Seoul National University College of Medicine, Bundang Hospital, Bundang, Korea (Y.J.L.); Department of Radiology, Korea University College of Medicine, Kuro Hospital, Seoul, Korea (Y.S.P., C.H.L.); Department of Radiology, Catholic University College of Medicine, Seoul St. Mary's Hospital, Seoul, Korea (S.E.R.); Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsan, Korea (S.P.); and Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea (W.J.L.).
Mi-Suk
MS
Park
D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D015179:Colorectal Neoplasms / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA