Preoperative detection of hepatic metastases: comparison of diffusion-weighted, T2-weighted fast spin echo and gadolinium-enhanced MR imaging using surgical and histopathologic findings as standard of reference.

Abstract

PURPOSE:

The purpose of this study was to retrospectively compare the respective sensitivities of diffusion-weighted (DW), T2-weighted fast spin-echo (T2WFSE) and gadolinium chelate-enhanced MR imaging in the preoperative detection of hepatic metastases using intraoperative ultrasonographic and histopathologic findings as the standard of reference.

MATERIALS AND METHODS:

Twenty-seven patients with 64 surgically and histopathologically proven hepatic metastases had MR imaging of the liver, including DW, T2WFSE and dynamic gadolinium chelate-enhanced MR imaging. Images from each MR sequence were separately analyzed by two readers with disagreements resolved by consensus readings. The findings on MR images were compared with intraoperative ultrasonographic and histopathologic findings on a lesion-by-lesion basis to determine the sensitivity of each MR sequence. Statistical review of the lesion-by-lesion analysis was performed with the McNemar test.

RESULTS:

DW, T2WFSE and gadolinium chelate-enhanced MR imaging allowed the depiction of 54/64 (84.4%; 95% CI: 73.1-92.2%), 44/64 (68.8%; 95% CI: 55.9-79.8%), and 51/64 (79.7%; 95% CI: 67.8-88.7%) hepatic metastases respectively. DW MR images allowed depiction of significantly more hepatic metastases than did T2WFSE and was equivalent to gadolinium chelate-enhanced MR imaging (P=.002 and P=.375, respectively).

CONCLUSION:

DW MR imaging is superior to T2WFSE imaging and equivalent to gadolinium chelate-enhanced MR imaging for the preoperative detection of hepatic metastases. Further studies however are needed to determine at what extent DW MR imaging can be used as an alternative to gadolinium chelate-enhanced MR imaging for the preoperative depiction of hepatic metastases.

• Authors: Philippe Soyer, Mourad Boudiaf, Vinciane Placé, Marc Sirol, Karine Pautrat, Alexandre Vignaud, Fabrice Staub, Djamel Tiah, Lounis Hamzi, Florent Duchat, Yann Fargeaudou, Marc Pocard
• Journal: European journal of radiology (Eur J Radiol) Vol. 80 Issue 2 Pg. 245-52 (Nov 2011) ISSN: 1872-7727 [Electronic] Ireland
• PMID: 20650588 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Contrast Media
• Heterocyclic Compounds
• Organometallic Compounds
• gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate

Topics

• Adult
• Aged
• Confidence Intervals
• Contrast Media
• Diffusion Magnetic Resonance Imaging
• Female
• Heterocyclic Compounds
• Humans
• Image Interpretation, Computer-Assisted
• Liver Neoplasms (diagnosis, diagnostic imaging, secondary, surgery)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Organometallic Compounds
• Retrospective Studies
• Sensitivity and Specificity
• Ultrasonography