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

1998 ◽  
Vol 7 (2) ◽  
pp. 76-87 ◽  
Author(s):  
Riccardo Lencioni ◽  
Francescamaria Donati ◽  
Dania Cioni ◽  
Alessandro Paolicchi ◽  
Antonio Cicorelli ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Spiral Ct ◽  
Dual Phase ◽  
Resonance Imaging ◽  
Arterial Portography ◽  
Ct During Arterial Portography ◽  
Prospective Comparison

scholarly journals Sensitivity of Magnetic Resonance Imaging in the Detection of Colorectal Liver Metastases

2008 ◽  
Vol 90 (1) ◽  
pp. 25-28 ◽  
Author(s):  
S Blyth ◽  
A Blakeborough ◽  
M Peterson ◽  
IC Cameron ◽  
AW Majeed
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Imaging Modality ◽  
Invasive Technique ◽  
Resonance Imaging ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
High Degree

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.

scholarly journals Intraoperative Ultrasound Staging for Colorectal Liver Metastases in the Era of Liver-Specific Magnetic Resonance Imaging: Is It Still Worthwhile?

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Serena Langella ◽  
Francesco Ardito ◽  
Nadia Russolillo ◽  
Elena Panettieri ◽  
Serena Perotti ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Intraoperative Ultrasound ◽  
Intrahepatic Recurrence ◽  
Oncologic Outcomes ◽  
Long Term Results ◽  
Resonance Imaging ◽  
Cut Surface

Background. To assess the efficacy of intraoperative ultrasound (IOUS) compared with liver-specific magnetic resonance imaging (MRI) in patients with colorectal liver metastases (CRLMs). Methods. From January 2010 to December 2017, 721 patients underwent MRI as a part of preoperative workup within 1 month before hepatectomy and were considered for the study. Early intrahepatic recurrence (relapse at cut surface excluded) was assessed 6 months after the resection and was considered as residual disease undetected by IOUS and/or MRI. IOUS and MRI performance was compared on a patient-by-patient basis. Long-term results were also studied. Results. A total of 2845 CRLMs were detected by MRI, and the median number of CRLMs per patient was 2 (1–31). Preoperative chemotherapy was administered in 489 patients (67.8%). In 177 patients, 379 new nodules were intraoperatively found and resected. Among 379 newly identified nodules, 317 were histologically proven CRLMs (11.1% of entire series). The median size of new CRLMs was 6 ± 2.5 mm. Relationships between intrahepatic vessels and tumors differed between IOUS and MRI in 128 patients (17.7%). The preoperative surgical plan was intraoperatively changed for 171 patients (23.7%). Overall, early intrahepatic recurrence occurred in 8.7% of cases. To assess the diagnostic performance, 24 (3.3%) recurrences at the cut surface were excluded; thus, 5.4% of early relapses were considered for analysis. The sensitivity of IOUS was superior to MRI (94.5% vs 75.1%), while the specificity was similar (95.7% vs 95.9%). Multivariate analysis at the hepatic dome or subglissonian and mucinous histology revealed predictive factors of metastases missing at MRI. The 5-year OS (52.1% vs 37.8%, p=0.006) and DF survival (45.1% vs 33%, p=0.002) were significantly worse among patients with new CRLMs than without. Conclusions. IOUS improves staging in patients undergoing resection for CRLMs even in the era of liver-specific MRI. Intraoperative detection of new CRLMs negatively affects oncologic outcomes.

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