Torkel B. Brismar MD, PhD, Presenter: Research supported, CMC Medical

Peter Aspelin MD, PhD, Abstract Co-Author: Speaker, General Electric Company Speaker, Bayer AG

Christian Kylander MD, Abstract Co-Author: Nothing to Disclose

Nils Albiin MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate the sensitivity of the oral MRI contrast agent CMC for detection of colon cancer metastases in liver.

20 patients, 10 men and 10 women, under evaluation for curative liver resection, with 1 – 6 suspected colorectal liver metastases participated in this study. The liver was imaged using MRI at 1.5 T in random order with one week interval either before and 3 hours after oral manganese (CMC-001, CMC Contrast AB) administration or after intravenous Gd-BOPTA (MulitHance, Bracco) using a 5–phase imaging protocol (native, arterio-portal, porto-venous, 5 min and 2 hours). Total scanner time was about 10+10 minutes for CMC and about 60+10 minutes for Gd-BOPTA. All exams and images were evaluated by two radiologists in consensus and the comparison was performed lesion by lesion. The number of metastases and their greatest diameter was recorded. The lesion to liver contrast was calculated as (liver signal – metastasis signal)/liver signal. Lesions were verified at histopathology after surgery (n=25), a combined evaluation of contrast enhanced ultrasound and Gd-BOPTA enhanced MRI (n=7), contrast enhanced ultrasound >3 months later (n=8), intra-operative contrast enhanced ultrasound (n=3) or contrast enhanced CT 3 months later (n=1).

In total there were 44 metastases. Of these 41 were detected after CMC-001 (sensitivity 93 %), 42 after Gd-BOPTA (sensitivity 95%) and 28 when no contrast media was used (sensitivity 64%). The smallest detected metastasis was 3 mm in diameter. The average contrast between tumor and liver was more than twice as great after CMC compared to after Gd-BOPTA (0.56 and 0.25 respectively, p<0.0001).

The orally administered manganese contrast media CMC-001 has a sensitivity as high as Gd-BOPTA to detect colon cancer liver metastases but requires shorter scanner time.

The short scanning time and the high sensitivity of the orally administered manganese contrast media CMC-001 gives it a high potential to be used for liver metastasis screening at colon cancer.

Brismar, T, Aspelin, P, Kylander, C, Albiin, N, CMC 001: A New Oral Contrast Media to Detect Liver Metastases&#8212Results from a Phase 3 Study.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8010168.html