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Eur Radiol. 2018 May 7. doi: 10.1007/s00330-018-5469-0. [Epub ahead of print]

Diagnostic accuracy of CE-CT, MRI and FDG PET/CT for detecting colorectal cancer liver metastases in patients considered eligible for hepatic resection and/or local ablation.

Author information

1
Department of Radiology, Aarhus University Hospital, NBG Noerrebrogade 44, 8000, Aarhus, Denmark. kimsives@rm.dk.
2
Department of Radiology, Aarhus University Hospital, NBG Noerrebrogade 44, 8000, Aarhus, Denmark.
3
Department of Hepatology & Gastroenterology, Aarhus University Hospital, NBG Noerrebrogade 44, 8000, Aarhus, Denmark.
4
Department of Nuclear Medicine & PET-Centre, Aarhus University Hospital, NBG Noerrebrogade 44, 8000, Aarhus, Denmark.
5
Department of Surgery (section for upper gastrointestinal and hepato-pancreato-biliary surgery), Aarhus University Hospital, NBG Noerrebrogade 44, 8000, Aarhus, Denmark.

Abstract

PURPOSE:

To compare the diagnostic performance of contrast-enhanced computed tomography (CE-CT), magnetic resonance imaging (MRI) and combined fluorodeoxyglucose/positron emission tomography/computed tomography (FDG-PET/CT) for detection of colorectal liver metastases (CRLM) in patients eligible for local treatment.

MATERIALS AND METHODS:

This health-research ethics-committee-approved prospective consecutive diagnostic accuracy study, with written informed consent, included 80 cases (76 patients, four participating twice) between 29 June 2015 and 7 February 2017. Prior chemotherapy or local treatment did not exclude participation. Combined FDG-PET/CT including CE-CT and MRI was performed within 0-3 days shortly before local treatment. CE-CT and MRI images were read independently by two readers for each modality. The combined FDG-PET/CT images were read independently by two pairs of readers. A composite reference standard was used. Sensitivities, specificities and area under the receiver operating characteristic curves (AUCROC) were calculated and compared.

RESULTS:

In total, 260 CRLMs were confirmed. The MRI readers had significantly higher per-lesion sensitivity (85.9% and 83.8%) than both CE-CT readers (69.1% and 62.3%) and both PET/CT reader pairs (72.0% and 72.1%) (p<0.001). There were no significant differences in per-lesion specificity. MRI readers had significantly higher AUCROC (0.92 and 0.88) than both CE-CT readers (0.80 and 0.82) (p≤0.001). AUCROC for MR reader 1 was higher than that of both PET/CT reader pairs (0.83 and 0.84) (p≤0.0001).

CONCLUSION:

MRI performed significantly better than both CE-CT and combined FDG-PET/CT for detection of CRLM in consecutive patients eligible for local treatment irrespective of prior chemotherapy or local treatment.

KEY POINTS:

• Patients eligible for local treatment of colorectal liver-metastases require optimal imaging. • In 80 consecutive patients, MRI had superior per lesion diagnostic performance. • Findings were independent of prior treatment and type of planned local treatment. • Equally, MRI had superior diagnostic performance on per segment basis.

KEYWORDS:

Colorectal neoplasms; Computed tomography; Magnetic resonance imaging; Neoplasm metastasis; Positron emission tomography computed tomography

PMID:
29736846
DOI:
10.1007/s00330-018-5469-0

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