Preoperative Detection of Hepatic Metastases from the colorectal Cancers: Comparison of Dual-phase CT scan, Mn-DPDP enhanced MRI, and combination of CT and MRI.
- Author:
Kyung Min SHIN
1
;
Hun Kyu RYEOM
;
Jong Yeol KIM
;
Gyu Seok CHOI
;
Hye Jeong KIM
;
Jong Min LEE
;
Yongmin CHANG
;
Yong Seon KIM
;
Duk Sik KANG
Author Information
1. Department of Radiology, School of Medicine, Kyungpook National University. hkryeom@knu.ac.kr
- Publication Type:Original Article
- Keywords:
Liver neoplasms, CT;
Liver neoplasmamms, MR;
Magnetic resonance (MR), contrast media
- MeSH:
Carcinoembryonic Antigen;
Colorectal Neoplasms*;
Diagnosis;
Humans;
Magnetic Resonance Imaging*;
Neoplasm Metastasis*;
ROC Curve;
Tomography, Spiral Computed;
Tomography, X-Ray Computed*;
Ultrasonography
- From:Journal of the Korean Society of Magnetic Resonance in Medicine
2005;9(2):109-116
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To determine the usefulness of additional Mn-DPDP MRI for preoperative evaluation of the patients with colorectal cancers by comparison of dual-phase CT scan, Mn-DPDP enhanced MRI and combination of CT and MRI. MATERIALS AND METHODS: Fifty-three colorectal cancer patients with 92 metastatic nodules underwent dualphase (arterial and portal) helical CT scan and Mn-DPDP MRI prior to surgery. The indication of MRI was presence or suspected of having metastatic lesions at CT scan and/or increased serum carcinoembryonic antigen (CEA) levels (10 ng/mL or more). The diagnosis was established by the combination of findings at surgery, intraoperative ultrasonography, and histopathologic examination. Two radiologists interpreted CT, MRI, and combination of CT-MRI at discrete sessions and evaluated each lesion for location, size, and intrinsic characteristics. The lesions were divided into three groups according to their diameter; 1cm <, 1-2 cm, and > 2 cm. Diagnostic accuracy was evaluated using the alternative-free response receiver operating characteristic method. Detection and false positive rate were also evaluated. RESULTS: In the lesions smaller than 1 cm, detection rate of combined CT-MRI was superior to CT or MRI alone (82%, p = 0.036). The mean accuracy (Az values) of combined CT and MRI was significantly higher than that of CT in the lesions smaller than 2 cm (1 cm <, p=0.034; 1-2 cm, p=0.045). However, there was no significant difference between MRI and combined CT-MRI. The false positive rate of CT was higher than those of combined CT-MR in the lesions smaller than 1 cm (28 %, p=0.023). CONCLUSION: Additional MRI using Mn-DPDP besides routine CT scan was helpful in differentiating the hepatic lesions (< 2 cm) and could improve detection of the small hepatic metastases (< 1 cm) from colorectal carcinoma.
