Detection of colorectal liver metastases: Prospective comparison of unenhanced and ferumoxides-enhanced magnetic resonance imaging at 1.5 T, dual-phase spiral CT, and spiral CT during arterial portography

Riccardo Lencioni, Francescamaria Donati, Dania Cioni, Alessandro Paolicchi, Antonio Cicorelli, Carlo Bartolozzi

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

The purpose of this study was to compare the efficacy of unenhanced and ferumoxides-enhanced magnetic resonance imaging with that of dual-phase spiral CT and spiral CT during arterial portography (CTAP) for the detection of colorectal liver metastases. Fourteen patients with liver metastases candidates for partial hepatectomy were examined with dual-phase spiral CT, unenhanced and ferumoxides-enhanced MR imaging at 1.5 T, and spiral CTAP. Imaging tests were read blinded, prospectively, quantitating number of lesions excepting CTAP which used US to exclude cysts. Subsequent intraoperative US and pathologic findings were correlated with preoperative imaging results. At surgery, 36 lesions 0.5-13 cm in diameter (mean ± standard deviation, 2.9 ± 2.1 cm) were identified. Dual-phase spiral CT depicted 21/36 (58%); precontrast MR imaging, 19/36 (53%); ferumoxides- enhanced MR imaging, 30/36 (83%); and spiral CTAP, 34/36 (94%) lesions. Ferumoxides-enhanced MR imaging was significantly more sensitive than spiral CT and unenhanced MR imaging (P <0.01). The difference in sensitivity between ferumoxides-enhanced MR imaging and spiral CTAP was not statistically significant (P > 0.1). Spiral CTAP, however, depicted nine false-positive lesions (2 hemangiomas, 7 perfusion defects). The positive predictive value was 79% for spiral CTAP and 100% for combined pre- and postcontrast MR imaging. We conclude that ferumoxides-enhanced MR imaging is superior to unenhanced MR imaging and biphasic spiral CT for depiction of colorectal liver metastases. Further investigation is needed to clarify whether MR imaging with use of ferumoxides might replace spiral CTAP for preoperative evaluation of liver resection candidates.

Original languageEnglish (US)
Pages (from-to)76-87
Number of pages12
JournalMagnetic Resonance Materials in Physics, Biology and Medicine
Volume7
Issue number2
DOIs
StatePublished - Dec 1998
Externally publishedYes

Fingerprint

Portography
Spiral Computed Tomography
Magnetic Resonance Imaging
Neoplasm Metastasis
Liver
ferumoxides
Hepatectomy
Hemangioma
Cysts
Perfusion

Keywords

  • Contrast media
  • Iron oxide
  • Liver neoplasms, CT
  • Liver neoplasms, diagnosis
  • Liver neoplasms, metastases
  • Liver neoplasms, MR
  • Liver neoplasms, staging

ASJC Scopus subject areas

  • Biophysics
  • Genetics

Cite this

Detection of colorectal liver metastases : Prospective comparison of unenhanced and ferumoxides-enhanced magnetic resonance imaging at 1.5 T, dual-phase spiral CT, and spiral CT during arterial portography. / Lencioni, Riccardo; Donati, Francescamaria; Cioni, Dania; Paolicchi, Alessandro; Cicorelli, Antonio; Bartolozzi, Carlo.

In: Magnetic Resonance Materials in Physics, Biology and Medicine, Vol. 7, No. 2, 12.1998, p. 76-87.

Research output: Contribution to journalArticle

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abstract = "The purpose of this study was to compare the efficacy of unenhanced and ferumoxides-enhanced magnetic resonance imaging with that of dual-phase spiral CT and spiral CT during arterial portography (CTAP) for the detection of colorectal liver metastases. Fourteen patients with liver metastases candidates for partial hepatectomy were examined with dual-phase spiral CT, unenhanced and ferumoxides-enhanced MR imaging at 1.5 T, and spiral CTAP. Imaging tests were read blinded, prospectively, quantitating number of lesions excepting CTAP which used US to exclude cysts. Subsequent intraoperative US and pathologic findings were correlated with preoperative imaging results. At surgery, 36 lesions 0.5-13 cm in diameter (mean ± standard deviation, 2.9 ± 2.1 cm) were identified. Dual-phase spiral CT depicted 21/36 (58{\%}); precontrast MR imaging, 19/36 (53{\%}); ferumoxides- enhanced MR imaging, 30/36 (83{\%}); and spiral CTAP, 34/36 (94{\%}) lesions. Ferumoxides-enhanced MR imaging was significantly more sensitive than spiral CT and unenhanced MR imaging (P <0.01). The difference in sensitivity between ferumoxides-enhanced MR imaging and spiral CTAP was not statistically significant (P > 0.1). Spiral CTAP, however, depicted nine false-positive lesions (2 hemangiomas, 7 perfusion defects). The positive predictive value was 79{\%} for spiral CTAP and 100{\%} for combined pre- and postcontrast MR imaging. We conclude that ferumoxides-enhanced MR imaging is superior to unenhanced MR imaging and biphasic spiral CT for depiction of colorectal liver metastases. Further investigation is needed to clarify whether MR imaging with use of ferumoxides might replace spiral CTAP for preoperative evaluation of liver resection candidates.",
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