Detection of liver metastasis: is diffusion-weighted imaging needed in Gd-EOB-DTPA-enhanced MR imaging for evaluation of colorectal liver metastases?

Abstract

PURPOSE:

We compared diagnostic ability for detecting hepatic metastases between gadolinium ethoxy benzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) on a 1.5-T system, and determined whether DWI is necessary in Gd-EOB-DTPA-enhanced MRI for diagnosing colorectal liver metastases.

MATERIALS AND METHODS:

We assessed 29 consecutive prospectively enrolled patients with suspected metachronous colorectal liver metastases; all patients underwent surgery and had preoperative Gd-EOB-DTPA-enhanced MRI. Overall detection rate, sensitivity for detecting metastases and benign lesions, positive predictive value, and diagnostic accuracy (Az value) were compared among three image sets [unenhanced MRI (DWI set), Gd-EOB-DTPA-enhanced MRI excluding DWI (EOB set), and combined set].

RESULTS:

Gd-EOB-DTPA-enhanced MRI yielded better overall detection rate (77.8-79.0 %) and sensitivity (87.1-89.4 %) for detecting metastases than the DWI set (55.9 % and 64.7 %, respectively) for one observer (P < 0.001). No statistically significant difference was seen between the EOB and combined sets, although several metastases were newly detected on additional DWI.

CONCLUSIONS:

Gd-EOB-DTPA-enhanced MRI yielded a better overall detection rate and higher sensitivity for detecting metastases compared with unenhanced MRI. Additional DWI may be able to reduce oversight of lesions in Gd-EOB-DTPA-enhanced 1.5-T MRI for detecting colorectal liver metastases.

• Authors: Taku Tajima, Masaaki Akahane, Hidemasa Takao, Hiroyuki Akai, Shigeru Kiryu, Hiroshi Imamura, Yasushi Watanabe, Norihiro Kokudo, Kuni Ohtomo
• Journal: Japanese journal of radiology (Jpn J Radiol) Vol. 30 Issue 8 Pg. 648-58 (Oct 2012) ISSN: 1867-108X [Electronic] Japan
• PMID: 22836904 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Contrast Media
• gadolinium ethoxybenzyl DTPA
• Gadolinium DTPA

Topics

• Adult
• Aged
• Aged, 80 and over
• Colorectal Neoplasms (pathology)
• Contrast Media
• Diffusion Magnetic Resonance Imaging
• Diffusion Tensor Imaging (methods)
• Female
• Gadolinium DTPA
• Humans
• Liver Neoplasms (diagnosis, secondary, surgery)
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Neoplasms, Second Primary (diagnosis)
• Predictive Value of Tests
• Prospective Studies
• Sensitivity and Specificity
• Tomography, X-Ray Computed
• Treatment Outcome