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Detection of colo-rectal liver metastases: prospective comparison of contrast enhanced US, multidetector CT, PET/CT, and 1.5 Tesla MR with extracellular and reticulo-endothelial cell specific contrast agents

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Abstract

Background

To compare contrast-enhanced US (CE-US), multidetector-CT (MDCT), 1.5 Tesla MR with extra-cellular (Gd-enhanced) and intracellular (SPIO-enhanced) contrast agents and PET/CT, in the detection of hepatic metastases from colorectal cancer.

Materials and methods

A total of 34 patients with colo-rectal adenocarcinoma underwent preoperatively CE-US, MDCT, Gd- and SPIO-enhanced MR imaging (MRI), and PET/CT. Each set of images was reviewed independently by two blinded observers. The ROC method was used to analyze the results, which were correlated with surgical findings, intraoperative US, histopathology, and MDCT follow-up.

Results

A total of 57 hepatic lesions were identified: 11 hemangiomas, 29 cysts, 1 focal fatty liver, 16 metastases (dimensional distribution: 5/16 < 5 mm; 3/16 between 5 mm and <10 mm; 8/16 ≥ 10 mm). Six of 34 patients were classified as positive for the presence of at least one metastasis. Considering all the metastases and those ≥10 mm, ROC areas showed no significant differences between Gd- and SPIO-enhanced MRI, which performed significantly better than the other modalities (P < 0.05). Considering the lesions <10 mm, ROC areas showed no significant differences between all modalities; however MRI presented a trend to perform better than the other techniques. Considering the patients, ROC areas showed no significant differences between all the modalities; however PET/CT seemed to perform better than the others.

Conclusions

Gd- and SPIO-enhanced MRI seem to be the most accurate modality in the identification of liver metastases from colo-rectal carcinoma. PET/CT shows a trend to perform better than the other modalities in the identification of patients with liver metastases.

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Authors and Affiliations

  1. IBB CNR, Via Pansini 5, 80131, Naples, Italy

    Pier Paolo Mainenti, Marcello Mancini, Antonio Speranza & Marco Salvatore

  2. Department of Biomorphological and Functional Sciences, Section of Radiology, University of Naples “Federico II”, Via Pansini 5, 80131, Naples, Italy

    Pier Paolo Mainenti, Marcello Mancini, Ciro Mainolfi, Luigi Camera, Simone Maurea, Antonietta Manchia, Michela Tanga, Leonardo Pace & Marco Salvatore

  3. Department of General Surgery, Geriatry and Endoscopy, University of Naples “Federico II”, Via Pansini 5, 80131, Naples, Italy

    Francesco Persico, Pietro Addeo & Giovanni Persico

  4. Department of General, Geriatric and Oncological Surgery and Advanced Techniques, University of Naples “Federico II”, Via Pansini 5, 80131, Naples, Italy

    Dario D’Antonio & Luigi Bucci

  5. Corso Vittorio Emanuele, 670, 80122, Naples, Italy

    Pier Paolo Mainenti

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Mainenti, P.P., Mancini, M., Mainolfi, C. et al. Detection of colo-rectal liver metastases: prospective comparison of contrast enhanced US, multidetector CT, PET/CT, and 1.5 Tesla MR with extracellular and reticulo-endothelial cell specific contrast agents. Abdom Imaging 35, 511–521 (2010). https://doi.org/10.1007/s00261-009-9555-2

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