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Diagnosis of colorectal hepatic metastases: Comparison of contrast‐enhanced CT, contrast‐enhanced US, superparamagnetic iron oxide‐enhanced MRI, and gadoxetic acid‐enhanced MRI
Author(s) -
Muhi Ali,
Ichikawa Tomoaki,
Motosugi Utaroh,
Sou Hironobu,
Nakajima Hiroto,
Sano Katsuhiro,
Sano Mika,
Kato Satoshi,
Kitamura Takatoshi,
Fatima Zareen,
Fukushima Kimiyo,
Iino Hiroshi,
Mori Yoshiyuki,
Fujii Hideki,
Araki Tsutomu
Publication year - 2011
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.22613
Subject(s) - gadoxetic acid , medicine , magnetic resonance imaging , nuclear medicine , colorectal cancer , radiology , receiver operating characteristic , computed tomography , cancer , gadolinium dtpa
Purpose: To compare the diagnostic accuracy of contrast‐enhanced computed tomography (CE‐CT), contrast‐enhanced ultrasonography (CE‐US), superparamagnetic iron oxide‐enhanced magnetic resonance imaging (SPIO‐MRI), and gadoxetic acid‐enhanced MRI (Gd‐EOB‐MRI) in the evaluation of colorectal hepatic metastases. Materials and Methods: In all, 111 patients with colorectal cancers were enrolled in this study. Of the 112 metastases identified in 46 patients, 31 in 18 patients were confirmed histologically and the remaining 81 in 28 patients were confirmed by follow‐up imaging. CE‐CT, CE‐US, SPIO‐MRI, and Gd‐EOB‐MRI were evaluated. Mean (of three readers, except for CE‐US) area under the receiver operating characteristic curve (A z ), sensitivities, and positive predictive values (PPV) were calculated. Each value was compared to the others by variance z‐test or chi‐square test with Bonferroni correction. Results: For all lesions, mean A z and sensitivity of Gd‐EOB‐MRI (0.992, 95% [56/59]) were significantly greater than those of CE‐CT (0.847, 63% [71/112]) and CE‐US (0.844, 73% [77/106]). For lesions ≤1 cm, mean A z and sensitivity of Gd‐EOB‐MRI (0.999, 92% [22/24]) were significantly greater than those of CE‐CT (0.685, 26% [13/50]) and CE‐US (0.7, 41% [18/44]). Mean A z (95% CI) of SPIO‐MRI for all lesions (0.966 [0.929–0.987]) and lesions ≤ 1 cm (0.961 [0.911–0.988]) were significantly greater than those of CE‐CT and CE‐US. Mean sensitivity of SPIO‐MRI for lesions ≤1 cm (63%, 26/41) was significantly greater than that of CE‐CT. Conclusion: Gd‐EOB‐MRI and SPIO‐MRI were more accurate than CE‐CT and CE‐US for evaluation of liver metastasis in patients with colorectal carcinoma. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.