Ozaki K, Ishida S, Higuchi S, Sakai T, Kitano A, Takata K, Kinoshita K, Matta Y, Ohtani T, Kimura H, Gabata T. Diagnostic performance of abbreviated gadoxetic acid-enhanced magnetic resonance protocols with contrast-enhanced computed tomography for detection of colorectal liver metastases . World J Radiol 2022; 14(10): 352-366 [PMID: 36340439 DOI: 10.4329/wjr.v14.i10.352]
Corresponding Author of This Article
Kumi Ozaki, MD, PhD, Lecturer, Department of Radiology, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Fukui 9101193, Japan. ozakik-rad@umin.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Oct 28, 2022; 14(10): 352-366 Published online Oct 28, 2022. doi: 10.4329/wjr.v14.i10.352
Diagnostic performance of abbreviated gadoxetic acid-enhanced magnetic resonance protocols with contrast-enhanced computed tomography for detection of colorectal liver metastases
Kumi Ozaki, Shohei Higuchi, Toyohiko Sakai, Ayaki Kitano, Kenji Takata, Kazuyuki Kinoshita, Yuki Matta, Takashi Ohtani, Hirohiko Kimura, Department of Radiology, University of Fukui, Fukui 9101193, Japan
Shota Ishida, Department of Radiological Technology, Faculty of Medical Science, Kyoto College of Medical Science, Kyoto 6220041, Japan
Toshifumi Gabata, Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa 9208641, Japan
Author contributions: Ozaki K contributed to the methodology and data curation; Ishida S contributed to the conceptualization; Higuchi S, Sakai T, Kitano A, Takata K and Kinoshita K contributed to the investigation; Ozaki K, Matta Y and Ohtani T contributed to the writing-original draft; Kimura H contributed to the methodology, writing-review and editing; Gabata T contributed to the supervision and project administration.
Institutional review board statement: This single-center retrospective study was approved by our institutional review board (No. 20210035).
Informed consent statement: The written informed consent was waived.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: The authors share all data.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kumi Ozaki, MD, PhD, Lecturer, Department of Radiology, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Fukui 9101193, Japan. ozakik-rad@umin.org
Received: August 14, 2022 Peer-review started: August 14, 2022 First decision: August 29, 2022 Revised: September 5, 2022 Accepted: October 5, 2022 Article in press: October 5, 2022 Published online: October 28, 2022 Processing time: 74 Days and 1.5 Hours
Abstract
BACKGROUND
Although contrast-enhanced magnetic resonance imaging (MRI) using gadoxetic acid has been shown to have higher accuracy, sensitivity, and specificity for the detection and characterization of hepatic metastases compared with other modalities, the long examination time would limit the broad indication. Several abbreviated enhanced MRI (Ab-MRI) protocols without dynamic phases have been proposed to achieve equivalent diagnostic performance for the detection of colorectal liver metastases. However, an optimal protocol has not been established, and no studies have assessed the diagnostic performance of Ab-MRI combined with contrast-enhanced computed tomography (CE-CT), which is the preoperative imaging of colorectal cancer staging in clinical settings, to determine the best therapeutic strategy.
AIM
To compare the diagnostic performance of two kinds of Ab-MRI protocol with the standard MRI protocol and a combination of the Ab-MRI protocol and CE-CT for the detection of colorectal liver metastases.
METHODS
Study participants comprised 87 patients (51 males, 36 females; mean age, 67.2 ± 10.8 years) who had undergone gadoxetic acid-enhanced MRI and CE-CT during the initial work-up for colorectal cancer from 2010 to 2021. Each exam was independently reviewed by two readers in three reading sessions: (1) Only single-shot fast spin echo (FSE) T2-weighted or fat-suppressed-FSE-T2-weighted, diffusion-weighted, and hepatobiliary-phase images (Ab-MRI protocol 1 or 2); (2) all acquired MRI sequences (standard protocol); and (3) a combination of an Ab-MRI protocol (1 or 2) and CE-CT. Diagnostic performance was then statistically analyzed.
RESULTS
A total of 380 Lesions were analyzed, including 195 metastases (51.4%). Results from the two Ab-MRI protocols were similar. The sensitivity, specificity, and positive and negative predictive values from Ab-MRI were non-inferior to those from standard MRI (P > 0.05), while those from the combination of Ab-MRI protocol and CE-CT tended to be higher than those from Ab-MRI alone, although the difference was not significant (P > 0.05), and were quite similar to those from standard MRI (P > 0.05).
CONCLUSION
The diagnostic performances of two Ab-MRI protocols were non-inferior to that of the standard protocol. Combining Ab-MRI with CE-CT provided better diagnostic performance than Ab-MRI alone.
Core Tip: For the detection of colorectal liver metastases, the diagnostic performance of two kinds of abbreviated enhanced magnetic resonance imaging (Ab-MRI) protocols was non-inferior to that of the standard protocol. The combination of Ab-MRI and contrast-enhanced computed tomography provided better diagnostic performance than that of Ab-MRI alone.
