Ji Won Oh MD, Presenter: Nothing to Disclose

Seung Beak Lee, Abstract Co-Author: Nothing to Disclose

Soon Nam Oh MD, Abstract Co-Author: Nothing to Disclose

Sung Eun Rha MD, Abstract Co-Author: Nothing to Disclose

Seung Eun Jung MD, Abstract Co-Author: Nothing to Disclose

Joon Il Choi MD, PhD, Abstract Co-Author: Nothing to Disclose

Ie Ryung Yoo, Abstract Co-Author: Nothing to Disclose

Jae Young Byun MD, Abstract Co-Author: Nothing to Disclose

To evaluate the added value of Gadoxetic acid-enhanced liver MRI in preoperative staging of colorectal cancer, and to estimate the clinical impact of the liver MRI in management planning of liver metastasis.

Among 140 Patients who underwent CT, FDG-PET, and consecutive Gadoxetic acid-enhanced liver MRI for preoperative evaluation of colorectal cancer, between January 2011 and December 2013, 41 patients with confirmed liver metastasis by subsequent surgery or follow-up imaging were included. Per patient sensitivity and specificity, and per-nodule sensitivity of FDG-PET and liver MRI at detecting metastatic nodules were evaluated according to the reading papers. The sensitivity for liver metastasis of FDG-PET and MRI were calculated in groups of tiny (<1cm), small (<2cm) and large (≥2cm) metastatic nodules. The newly detected metastatic nodules on liver MRI were analyzed, to assess the treatment change after performing liver MRI.

A total of 131 metastatic nodules (size 1.6 cm; range 0.4-8.2) were detected in 41 patients (mean age 65 years; range 37-81). The sensitivity and the specificity of FDG-PET and liver MRI did not differ significantly on per patient base. The per nodule sensitivity of FDG-PET(68.7%) and liver MRI (96.2%) were significantly different (P = 0.0001), especially for small (<2 cm) nodules. The sensitivity of FDG-PET and MRI were 59.8%, 95.1%, for small nodules and 27.1%, 91.7% for tiny nodule, respectively. The mean diameter of metastatic nodules was significantly different between FDG-PET negative (0.75 cm) and FDG-PET positive (1.98 cm) nodules (P = 0.0001). At least one more metastatic nodule was newly detected on MRI in 16 (39%) patients. Among these, 6 (15%) patients showed significant change of the management plan after performing liver MRI.

Gadoxetic acid-enhanced liver MRI detected more metastatic nodules compared with FDG-PET, especially for small (< 2 cm) nodules. Excellent small nodule detection of Gadoxetic acid-enhanced liver MRI is helpful for treatment planning of liver metastasis in colorectal cancer. 

FDG-PET or Gadoxetic acid-enhanced MRI are used for evaluation of suspicious metastatic lesion in patients with colorectal cancer. For hepatic metastases, Gadoxetic acid-enhanced MRI shows excellent detection of liver metastasis regardless of size and may be a helpful decision maker for treatment planning. 

Oh, J, Lee, S, Oh, S, Rha, S, Jung, S, Choi, J, Yoo, I, Byun, J, Does the Gadoxetic Acid-enhanced Liver MRI Impact on the Treatment of Patients with Colorectal Cancer? Comparison Study with FDG-PET and Gadoxetic Acid-enhanced MRI .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14017692.html