The role of diffusion-weighted imaging in the detection of hepatic metastases from colorectal cancer: A comparison with unenhanced and Gd-EOB-DTPA enhanced MRI

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• 作者：Stefano Colagrande^a ; ^{stefano.colagrande@unifi.it" class="auth_mail" title="E-mail the corresponding author} ; Alessandro Castellani^a ; ^{ale.andro@hotmail.it" class="auth_mail" title="E-mail the corresponding author} ; Cosimo Nardi^a ; ^{cosimo.nardi@unifi.it" class="auth_mail" title="E-mail the corresponding author} ; Chiara Lorini^b ; ^{chiara.lorini@unifi.it" class="auth_mail" title="E-mail the corresponding author} ; Linda Calistri^a ; ^{linda.calistri@unifi.it" class="auth_mail" title="E-mail the corresponding author} ; Antonella Filippone^c ; ^{a.filippone@rad.unich.it" class="auth_mail" title="E-mail the corresponding author}
• 关键词：DWI ; diffusion weighted imaging ; MR ; magnetic resonance ; MRI ; magnetic resonance imaging ; CA ; contrast agent ; Gd-EOB-DTPA ; gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid ; IOUS ; intraoperative ultrasound ; IV ; intravenous ; ADC ; apparent diffusion coefficient ; FNH ; focal nodular hyperplasia ; FLL ; focal liver lesion
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：85
• 期：5
• 页码：1027-1034
• 全文大小：1464 K

文摘

To compare the role of DWI vs. gadoxetic-acid-disodium enhanced MRI in the detection of colorectal hepatic metastases.

Methods

Fifty-four patients with 115 hepatic metastases were included in this retrospective study, approved by the Ethical Board. All patients underwent intraoperative-ultrasound and surgical resection within two weeks after MRI. Images were grouped in 4 sets, which were analyzed by two radiologists in different sessions: unenhanced T1-T2w (set A), set A plus DWI (set B), set A plus gadoxetic-acid-disodium (set C), set A plus DWI plus gadoxetic-acid-disodium (set D). For each set, metastases presence/size/site was reported. Interobserver agreement and statistical significance were assessed by Cohen’s kappa and Mc-Nemar’s test, respectively.

Results

Readers’ agreement was always very good (k > 0.80). Mean sensitivity values were 84.3/92.1/95.6/97.3% for set A/B/C/D, respectively. Mean specificity, positive predicted, negative predicted, and accuracy values strongly and progressively increased in the various set too: from 62.5% (set A) to 85.0% as for specificity, from 92.8% to 97.3% as for positive predicted value, from 41.0% to 85.1% as for negative predicted value, and from 81.1% to 95.5% as for accuracy.

For each reader from set A to D, the number of false negatives progressively decreases.

Conclusions

For both readers, DWI improved all statistical parameters in the unenhanced examinations, as for nodules either smaller or greater than 1 cm, while in the EOB-enhanced examinations DWI prevalently increased specificity/negative predictive value.