Preoperative detection of colorectal liver metastases: DWI alone or combined with MDCT is no substitute for Gd-EOB-DTPA-enhanced MRI

2019 ◽  
Vol 61 (3) ◽  
pp. 302-311
Author(s):  
Anselm Schulz ◽  
Eivind Selstø Joelsen-Hatlehol ◽  
Kristoffer Watten Brudvik ◽  
Kjersti Karoline Aasand ◽  
Bettina Hanekamp ◽  
...  

Background Magnetic resonance imaging (MRI) with hepatocyte specific contrast has the highest sensitivity for colorectal liver metastases but comes at high costs and long examination times. Purpose To evaluate if preoperative detection of colorectal liver metastases with less resource-consuming diffusion-weighted imaging (DWI) alone or in combination with multidetector computed tomography (MDCT) can compete with gadolinium-etoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MRI. Material and Methods Forty-four patients with 123 colorectal liver metastases received MDCT and Gd-EOB-DTPA-enhanced MRI including DWI before liver resection for colorectal liver metastases. Five image sets were evaluated by two radiologists. The DWI set consisted of DWI, ADC map, coronal, axial T2-weighted single-shot sequences. The DWI-T2F set contained additionally respiratory-triggered T2-weighted TSE-SPIR sequences. The MDCT set consisted of four-phase MDCT, the MDCT-DWI set also contained DWI. The CE-MRI set contained all MRI sequences including Gd-EOB-DTPA. Reference standards was histopathology and follow-up. Results CE-MRI set had highest sensitivity ( P ≤ 0.013) with 95% compared to 72%, 73%, 73%, and 87% the for DWI set, DWI-T2W-FS set, MDCT set, and MDCT-DWI set, respectively. The CE-MRI set had the highest sensitivity ( P≤0.012) for colorectal liver metastases <10 mm with 87% compared to 55%, 52%, 23%, and 58% for the DWI set, DWI-T2W-FS set, MDCT set, and MDCT-DWI set, respectively. The MDCT-DWI set improved sensitivity overall and in size-dependent subgroup analyses compared to the MDCT set ( P ≤ 0.031). The MDCT-DWI set showed the highest specificity of 98% followed by 98%, 98%, 95%, and 88% for the DWI set, DWI-T2W-FS set, MDCT set, and CE-MRI set, respectively. Conclusion The less resource and time-consuming DWI sets are inferior to Gd-EOB-DTPA-enhanced MRI for the detection of colorectal liver metastases. Gd-EOB-DTPA-enhanced MRI with its excellent sensitivity should be the preferred preoperative modality when meticulous lesion identification is essential. Combination of DWI with MDCT improved significantly sensitivity compared to each modality alone.

2008 ◽  
Vol 90 (1) ◽  
pp. 25-28 ◽  
Author(s):  
S Blyth ◽  
A Blakeborough ◽  
M Peterson ◽  
IC Cameron ◽  
AW Majeed

INTRODUCTION The aim of this study was to evaluate the sensitivity of magnetic resonance imaging (MRI) in the detection of colorectal liver metastases. PATIENTS AND METHODS Pre-operative MRI scanning of the liver was performed by a single radiologist and the size and number of definite liver metastases were recorded. Patients then underwent hepatectomy with routine intra-operative ultrasonography (IOUS) and resected specimens were sent for histopathology. Pathology findings were compared with those of MRI scans to determine the sensitivity of this imaging modality. Exclusions were patients undergoing hepatic resection more than 4 weeks after the MRI scan, those undergoing chemotherapy at the time of the scan, and those with conglomerate unilobar metastases. RESULTS Complete data were available for 84 patients. There was total agreement between MRI, IOUS and histology in 79 patients (101 metastases). MRI missed 5 metastases in 5 patients that were found on IOUS (or palpation of superficial lesions) and subsequently confirmed by histological examination. These measured 5 mm or less (4 patients) and 7 mm (one patient). The sensitivity of MRI in the detection of colorectal liver metastases was thus 94% for all lesions and 100% for lesions 1 cm or larger in diameter. CONCLUSIONS MRI of the liver is a non-invasive technique with an extremely high degree of sensitivity in the detection of colorectal liver metastases and should be considered as the ‘gold standard’ in the pre-operative imaging of these patients.


Swiss Surgery ◽  
2000 ◽  
Vol 6 (1) ◽  
pp. 6-10
Author(s):  
Knoefel ◽  
Brunken ◽  
Neumann ◽  
Gundlach ◽  
Rogiers ◽  
...  

Die komplette chirurgische Entfernung von Lebermetastasen bietet Patienten nach kolorektalem Karzinom die einzige kurative Chance. Es gibt jedoch eine, anscheinend unbegrenzte, Anzahl an Parametern, die die Prognose dieser Patienten bestimmen und damit den Sinn dieser Therapie vorhersagen können. Zu den am häufigsten diskutierten und am einfachsten zu bestimmenden Parametern gehört die Anzahl der Metastasen. Ziel dieser Studie war es daher die Wertigkeit dieses Parameters in der Literatur zu reflektieren und unsere eigenen Patientendaten zu evaluieren. Insgesamt konnte von 302 Patienten ein komplettes Follow-up erhoben werden. Die gebildeten Patientengruppen wurden mit Hilfe einer Kaplan Meier Analyse und konsekutivem log rank Test untersucht. Die Literatur wurde bis Dezember 1998 revidiert. Die Anzahl der Metastasen bestätigte sich als ein prognostisches Kriterium. Lagen drei oder mehr Metastasen vor, so war nicht nur die Wahrscheinlichkeit einer R0 Resektion deutlich geringer (17.8% versus 67.2%) sondern auch das Überleben der Patienten nach einer R0 Resektion tendenziell unwahrscheinlicher. Das 5-Jahres Überleben betrug bei > 2 Metastasen 9% bei > 2 Metastasen 36%. Das 10-Jahres Überleben beträgt bislang bei > 2 Metastasen 0% bei > 2 Metastasen 18% (p < 0.07). Die Anzahl der Metastasen spielt in der Prognose der Patienten mit kolorektalen Lebermetastasen eine Rolle. Selbst bei mehr als vier Metastasen ist jedoch gelegentlich eine R0 Resektion möglich. In diesen Fällen kann der Patient auch langfristig von einer Operation profitieren. Das wichtigere Kriterium einer onkologisch sinnvollen Resektabilität ist die Frage ob technisch und funktionell eine R0 Resektion durchführbar ist. Ist das der Fall, so sollte auch einem Patienten mit mehreren Metastasen die einzige kurative Chance einer Resektion nicht vorenthalten bleiben.


2021 ◽  
pp. 088307382110162
Author(s):  
Xu Li ◽  
Qing Wang

Objectives: We analyzed the magnetic resonance imaging (MRI) manifestations of fetal corpus callosum abnormalities and discussed their prognosis based on the results of postnatal follow up. Methods: One hundred fifty-five fetuses were diagnosed with corpus callosum abnormalities by MRI at our hospital from 2004 to 2019. Gesell Development Scales were used to evaluate the prognosis of corpus callosum abnormalities after birth. Results: Corpus callosum abnormalities were diagnosed in 149 fetuses from singleton pregnancies, and 6 pairs of twins, 1 in each pair is a corpus callosum abnormality. Twenty-seven cases (27/155) were lost to follow up, whereas 128 cases (128/155) were followed up. Of these, 101 cases were induced for labor, whereas 27 cases were born naturally. Among the 27 cases of corpus callosum abnormality after birth, 22 cases were from singleton pregnancies (22/27). Moreover, 1 twin from each of 5 pairs of twins (5/27) demonstrated corpus callosum abnormalities. The average Gesell Development Scale score was 87.1 in 19 cases of agenesis of the corpus callosum and 74.9 in 3 cases of hypoplasia of the corpus callosum. Among the 5 affected twins, 2 had severe neurodevelopmental delay, 2 had mild neurodevelopmental delay, and 1 was premature and died. Conclusion: The overall prognosis of agenesis of the corpus callosum is good in singleton pregnancies. Hypoplasia of the corpus callosum is often observed with other abnormalities, and the development quotient of hypoplasia of the corpus callosum is lower compared with agenesis of the corpus callosum. Corpus callosum abnormalities may occur in one twin, in whom the risk may be increased.


2015 ◽  
Vol 59 (2) ◽  
pp. 317-319
Author(s):  
Zbigniew Adamiak ◽  
Yauheni Zhalniarovich ◽  
Paulina Przyborowska ◽  
Joanna Głodek ◽  
Adam Przeworski

AbstractThe aim of the study was to identify magnetic resonance imaging (MRI) sequences that contribute to a quick and reliable diagnosis of brachial plexus tumours in dogs. The tumours were successfully diagnosed in 6 dogs by the MRI with the use of SE, FSE, STIR, Turbo 3 D, 3D HYCE, and GE sequences and the gadolinium contrast agent


Author(s):  
Ida Sofie Grønningsæter ◽  
Aymen Bushra Ahmed ◽  
Nils Vetti ◽  
Silje Johansen ◽  
Øystein Bruserud ◽  
...  

The increasing use of radiological examination, especially magnetic resonance imaging (MRI), will probably increase the risk of unintended discovery of bone marrow abnormalities in patients where a hematologic disease would not be expected. In this paper we present four patients with different hematologic malignancies of nonplasma cell types. In all patients the MRI bone marrow abnormalities represent an initial presentation of the disease. These case reports illustrate the importance of a careful diagnostic follow-up without delay of patients with MRI bone marrow abnormalities, because such abnormalities can represent the first sign of both acute promyelocytic leukemia as well as other variants of acute leukemia.


2017 ◽  
Vol 23 ◽  
pp. 2168-2178 ◽  
Author(s):  
Jiang-bo Qin ◽  
Zhenyu Liu ◽  
Hui Zhang ◽  
Chen Shen ◽  
Xiao-chun Wang ◽  
...  

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