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HPB (Oxford). 2019 Oct 19. pii: S1365-182X(19)30721-X. doi: 10.1016/j.hpb.2019.09.009. [Epub ahead of print]

Additional value of gadoxetic acid-enhanced MRI to conventional extracellular gadolinium-enhanced MRI for the surgical management of colorectal and neuroendocrine liver metastases.

Author information

1
CHU de Québec - Université Laval, 11 Côte du Palais, Quebec, G1R 2J6 QC, Canada. Electronic address: Claudya.Morin.1@ULaval.ca.
2
CHU de Québec - Université Laval, 11 Côte du Palais, Quebec, G1R 2J6 QC, Canada.
3
Foothills Medical Centre - University of Calgary, 1403 29 St NW, Calgary, T2N 2T9 Alberta, Canada.

Abstract

BACKGROUND:

Liver resection being the only potentially curative treatment for patients with liver metastasis, it is critical to select the appropriate preoperative imaging modality. The aim of this study was to assess the impact of preoperative gadoxetic acid-enhanced MRI compared to a conventional extracellular gadolinium-enhanced MRI on the surgical management of colorectal and neuroendocrine liver metastasis.

METHODS:

We included 110 patients who underwent both a gadoxetic acid-enhanced MRI (hepatospecific contrast) and conventional extracellular gadolinium for the evaluation of colorectal or neuroendocrine liver metastases, from January 2012 to December 2015 at the CHU de Québec - Université Laval. When the number of lesions differed, a hepatobiliary surgeon evaluated if the gadoxetic acid-enhanced MRI modified the surgical management.

RESULTS:

Gadoxetic acid-enhanced MRI found new lesions in 25 patients (22.7%), excluded lesions in 18 patients (16.4%) and identified the same number in 67 patients (60.9%). The addition of the gadoxetic acid-enhanced MRI directly altered the surgical management in 19 patients overall (17.3% (95% CI [10.73-25.65])).

CONCLUSION:

Despite the additional cost associated with gadoxetic acid-enhanced MRI compared to conventional extracellular gadolinium-enhanced MRI, the use of this contrast agent has a significant impact on the surgical management of patients with liver metastases.

PMID:
31640929
DOI:
10.1016/j.hpb.2019.09.009

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