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Acta Radiol. 2019 Apr;60(4):441-450. doi: 10.1177/0284185118788901. Epub 2018 Aug 21.

Non-contrast liver MRI as an alternative to gadoxetic acid-enhanced MRI for liver metastasis from colorectal cancer.

Author information

1
1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2
2 Department of Radiology, Soonchunhyang University College of Medicine, Cheonan hospital, Cheonan, Republic of Korea.
3
3 Department of Radiology, Chungnam National University Hospital, Chungnam National University of College of Medicine, Daejeon, Republic of Korea.
4
4 Statistics and Data Center, Samsung Medical Center, Seoul, Republic of Korea.

Abstract

BACKGROUND:

Liver magnetic resonance imaging (MRI) provides reliable diagnostic performance for detecting liver metastasis but is costly and time-consuming.

PURPOSE:

To compare the diagnostic performance of non-contrast liver MRI to whole MRI using gadoxetic acid for detecting liver metastasis in patients with colorectal cancer (CRC).

MATERIAL AND METHODS:

We included 175 patients with histologically confirmed 401 liver metastases and 73 benign liver lesions. A non-contrast MRI (T1-weighted, T2-weighted, and diffusion-weighted images) with or without multidetector computed tomography (MDCT) and a whole MRI (gadoxetic acid-enhanced and non-contrast MRI) were analyzed independently by two observers to detect liver metastasis using receiver operating characteristic analysis.

RESULTS:

We found no significant differences in Az value (range = 0.914-0.997), sensitivity (range = 95.2-99.6%), specificity (range = 77.3-100%), or positive (range = 92.9-100%) or negative predictive value (range = 87.5-95.7%) between the non-contrast MRI with or without MDCT and the whole MRI for both observers for all lesions as well as lesions ≤1.0 cm and lesions >1.0 cm in size ( P = 0.203-1.000). Combined MDCT and non-contrast MRI led to similar numbers of false-positive diagnosis to the whole MRI (eight for Observers 1 and 4 vs. 3 for Observer 2).

CONCLUSION:

Non-contrast liver MRI may serve as an alternative to gadoxetic acid-enhanced MRI for detecting and characterizing liver metastasis from CRC, at least in patients with relatively high risk of liver metastasis who underwent MDCT. Non-contrast liver MRI could be beneficial especially for patients with lesions that are already documented as benign but require additional follow-up MRIs.

KEYWORDS:

Liver; MRI; colorectal cancer; contrast agents; intravenous; metastases

PMID:
30130970
DOI:
10.1177/0284185118788901
[Indexed for MEDLINE]

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