Abbreviated MRI protocol for colorectal liver metastases: How the radiologist could work in pre surgical setting

MRI is the most reliable imaging modality that allows to assess liver metastases. Our purpose is to compare the per-lesion and per-patient detection rate of gadoxetic acid-(Gd-EOB) enhanced liver MRI and fast MR protocol including Diffusion Weighted Imaging (DWI) and T2-W Fat Suppression sequence in...

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Bibliographic Details
Published in:PloS one 2020-11, Vol.15 (11), p.e0241431-e0241431
Main Authors: Granata, Vincenza, Fusco, Roberta, Avallone, Antonio, Cassata, Antonino, Palaia, Raffaele, Delrio, Paolo, Grassi, Roberta, Tatangelo, Fabiana, Grazzini, Giulia, Izzo, Francesco, Petrillo, Antonella
Format: Article
Language:English
Subjects:
Acids
Adult
Aged
Biology and Life Sciences
Cancer metastasis
Colorectal cancer
Colorectal Neoplasms - diagnostic imaging
Colorectal Neoplasms - surgery
Cytokeratin
Diagnosis
Diffusion rate
Female
Gadolinium
Humans
Lesions
Liver
Liver cancer
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - surgery
Magnetic Resonance Imaging
Male
Medical imaging
Medicine and Health Sciences
Metastases
Metastasis
Methods
Middle Aged
Morphology
Oncology
Patients
People and Places
Radiologists
Radiology
Research and Analysis Methods
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Summary:MRI is the most reliable imaging modality that allows to assess liver metastases. Our purpose is to compare the per-lesion and per-patient detection rate of gadoxetic acid-(Gd-EOB) enhanced liver MRI and fast MR protocol including Diffusion Weighted Imaging (DWI) and T2-W Fat Suppression sequence in the detection of liver metastasis in pre surgical setting. One hundred and eight patients with pathologically proven liver metastases (756 liver metastases) underwent Gd-EOBMRI were enrolled in this study. Three radiologist independently graded the presence of liver lesions on a five-point confidence scale assessed only abbreviated protocol (DWI and sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) fat suppressed sequence) and after an interval of more than 2 weeks the conventional study (all acquired sequences). Per-lesion and per-patient detection rate of metastases were calculated. Weighted к values were used to evaluate inter-reader agreement of the confidence scale regarding the presence of the lesion. MRI detected 732 liver metastases. All lesions were identified both by conventional study as by abbreviated protocol. In terms of per-lesion detection rate of liver metastasis, all three readers had higher detection rate both with abbreviated protocol and with standard protocol with Gd-EOB (96.8% [732 of 756] vs. 96.5% [730 of 756] for reader 1; 95.8% [725 of 756] vs. 95.2% [720 of 756] for reader 2; 96.5% [730 of 756] vs. 96.5% [730 of 756] for reader 3). Inter-reader agreement of lesions detection rate between the three radiologists was excellent (k range, 0.86-0.98) both for Gd-EOB MRI and for Fast protocol (k range, 0.89-0.99). Abbreviated protocol showed the same detection rate than conventional study in detection of liver metastases.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0241431