Combining diffusion-weighted MRI with Gd-EOB-DTPA-enhanced MRI improves the detection of colorectal liver metastases.

Abstract

OBJECTIVES:

To compare the diagnostic accuracy of gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MRI, diffusion-weighted MRI (DW-MRI) and a combination of both techniques for the detection of colorectal hepatic metastases.

METHODS:

72 patients with suspected colorectal liver metastases underwent Gd-EOB-DTPA MRI and DW-MRI. Images were retrospectively reviewed with unenhanced T(1) and T(2) weighted images as Gd-EOB-DTPA image set, DW-MRI image set and combined image set by two independent radiologists. Each lesion detected was scored for size, location and likelihood of metastasis, and compared with surgery and follow-up imaging. Diagnostic accuracy was compared using receiver operating characteristics and interobserver agreement by kappa statistics.

RESULTS:

417 lesions (310 metastases, 107 benign) were found in 72 patients. For both readers, diagnostic accuracy using the combined image set was higher [area under the curve (Az)=0.96, 0.97] than Gd-EOB-DTPA image set (Az=0.86, 0.89) or DW-MRI image set (Az=0.93, 0.92). Using combined image set improved identification of liver metastases compared with Gd-EOB-DTPA image set (p<0.001) or DW-MRI image set (p<0.001). There was very good interobserver agreement for lesion classification (κ=0.81-0.88).

CONCLUSIONS:

Combining DW-MRI with Gd-EOB-DTPA-enhanced T(1) weighted MRI significantly improved the detection of colorectal liver metastases.

• Authors: D-M Koh, D J Collins, T Wallace, I Chau, A M Riddell
• Journal: The British journal of radiology (Br J Radiol) Vol. 85 Issue 1015 Pg. 980-9 (Jul 2012) ISSN: 1748-880X [Electronic] England
• PMID: 22167501 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Contrast Media
• gadolinium ethoxybenzyl DTPA
• Gadolinium DTPA

Topics

• Aged
• Cohort Studies
• Colorectal Neoplasms (pathology, therapy)
• Contrast Media
• Diffusion Magnetic Resonance Imaging (methods)
• Female
• Gadolinium DTPA
• Humans
• Image Interpretation, Computer-Assisted
• Liver Neoplasms (diagnosis, secondary)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Neoplasm Staging (methods)
• Quality Improvement
• Retrospective Studies
• Sensitivity and Specificity