Diagnostic accuracy of CE-CT, MRI and FDG PET/CT for detecting colorectal cancer liver metastases in patients considered eligible for hepatic resection and/or local ablation
Purpose To compare the diagnostic performance of contrast-enhanced computed tomography (CE-CT), magnetic resonance imaging (MRI) and combined fluorodeoxyglucose/positron emission tomography/computed tomography (FDG-PET/CT) for detection of colorectal liver metastases (CRLM) in patients eligible for local treatment. Materials and methods This health-research ethics-committee-approved prospective consecutive diagnostic accuracy study, with written informed consent, included 80 cases (76 patients, four participating twice) between 29 June 2015 and 7 February 2017. Prior chemotherapy or local treatment did not exclude participation. Combined FDG-PET/CT including CE-CT and MRI was performed within 0–3 days shortly before local treatment. CE-CT and MRI images were read independently by two readers for each modality. The combined FDG-PET/CT images were read independently by two pairs of readers. A composite reference standard was used. Sensitivities, specificities and area under the receiver operating characteristic curves ($ AUC_{ROC} $) were calculated and compared. Results In total, 260 CRLMs were confirmed. The MRI readers had significantly higher per-lesion sensitivity (85.9% and 83.8%) than both CE-CT readers (69.1% and 62.3%) and both PET/CT reader pairs (72.0% and 72.1%) (p<0.001). There were no significant differences in per-lesion specificity. MRI readers had significantly higher $ AUC_{ROC} $ (0.92 and 0.88) than both CE-CT readers (0.80 and 0.82) (p≤0.001). $ AUC_{ROC} $ for MR reader 1 was higher than that of both PET/CT reader pairs (0.83 and 0.84) (p≤0.0001). Conclusion MRI performed significantly better than both CE-CT and combined FDG-PET/CT for detection of CRLM in consecutive patients eligible for local treatment irrespective of prior chemotherapy or local treatment. Key Points • Patients eligible for local treatment of colorectal liver-metastases require optimal imaging. • In 80 consecutive patients, MRI had superior per lesion diagnostic performance. • Findings were independent of prior treatment and type of planned local treatment. • Equally, MRI had superior diagnostic performance on per segment basis..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
European radiology - 28(2018), 11 vom: 07. Mai, Seite 4735-4747 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sivesgaard, Kim [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Colorectal neoplasms |
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| Anmerkungen: |
© European Society of Radiology 2018 |
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| doi: |
10.1007/s00330-018-5469-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC2092307908 |
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| 245 | 1 | 0 | |a Diagnostic accuracy of CE-CT, MRI and FDG PET/CT for detecting colorectal cancer liver metastases in patients considered eligible for hepatic resection and/or local ablation |
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| 520 | |a Purpose To compare the diagnostic performance of contrast-enhanced computed tomography (CE-CT), magnetic resonance imaging (MRI) and combined fluorodeoxyglucose/positron emission tomography/computed tomography (FDG-PET/CT) for detection of colorectal liver metastases (CRLM) in patients eligible for local treatment. Materials and methods This health-research ethics-committee-approved prospective consecutive diagnostic accuracy study, with written informed consent, included 80 cases (76 patients, four participating twice) between 29 June 2015 and 7 February 2017. Prior chemotherapy or local treatment did not exclude participation. Combined FDG-PET/CT including CE-CT and MRI was performed within 0–3 days shortly before local treatment. CE-CT and MRI images were read independently by two readers for each modality. The combined FDG-PET/CT images were read independently by two pairs of readers. A composite reference standard was used. Sensitivities, specificities and area under the receiver operating characteristic curves ($ AUC_{ROC} $) were calculated and compared. Results In total, 260 CRLMs were confirmed. The MRI readers had significantly higher per-lesion sensitivity (85.9% and 83.8%) than both CE-CT readers (69.1% and 62.3%) and both PET/CT reader pairs (72.0% and 72.1%) (p<0.001). There were no significant differences in per-lesion specificity. MRI readers had significantly higher $ AUC_{ROC} $ (0.92 and 0.88) than both CE-CT readers (0.80 and 0.82) (p≤0.001). $ AUC_{ROC} $ for MR reader 1 was higher than that of both PET/CT reader pairs (0.83 and 0.84) (p≤0.0001). Conclusion MRI performed significantly better than both CE-CT and combined FDG-PET/CT for detection of CRLM in consecutive patients eligible for local treatment irrespective of prior chemotherapy or local treatment. Key Points • Patients eligible for local treatment of colorectal liver-metastases require optimal imaging. • In 80 consecutive patients, MRI had superior per lesion diagnostic performance. • Findings were independent of prior treatment and type of planned local treatment. • Equally, MRI had superior diagnostic performance on per segment basis. | ||
| 650 | 4 | |a Colorectal neoplasms | |
| 650 | 4 | |a Neoplasm metastasis | |
| 650 | 4 | |a Magnetic resonance imaging | |
| 650 | 4 | |a Computed tomography | |
| 650 | 4 | |a Positron emission tomography computed tomography | |
| 700 | 1 | |a Larsen, Lars P. |4 aut | |
| 700 | 1 | |a Sørensen, Michael |4 aut | |
| 700 | 1 | |a Kramer, Stine |4 aut | |
| 700 | 1 | |a Schlander, Sven |4 aut | |
| 700 | 1 | |a Amanavicius, Nerijus |4 aut | |
| 700 | 1 | |a Bharadwaz, Arindam |4 aut | |
| 700 | 1 | |a Tønner Nielsen, Dennis |4 aut | |
| 700 | 1 | |a Viborg Mortensen, Frank |4 aut | |
| 700 | 1 | |a Morre Pedersen, Erik |4 aut | |
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