Use of Imaging to Predict Complete Response of Colorectal Liver Metastases after Chemotherapy: MR Imaging versus CT Imaging.
Radiology. 2017 Mar 22:161619. doi: 10.1148/radiol.2017161619. [Epub ahead of print] Park MJ1, Hong N1, Han K1, Kim MJ1, Lee YJ1, Park YS1, Rha SE1, Park S1, Lee WJ1, Park SH1, Lee CH1, Nam CM1, An C1, Kim HJ1, Kim H1, Park MS1.
Purpose: To compare the diagnostic performances of contrast agent-enhanced computed tomography (CT) and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced liver magnetic resonance (MR) imaging (referred to as EOB MR imaging) in the evaluation of disappearing colorectal liver metastases (CRLMs) after chemotherapy.
Materials and Methods: The eight institutional review boards approved this retrospective study and waived the requirement for informed consent. On the basis of retrospective searches in eight hospitals, 87 patients with 393 CRLMs, each patient with one or more CRLM that later disappeared on contrast-enhanced CT scans after chemotherapy, and subsequently underwent surgery for the CRLMs, were enrolled. The anonymized imaging data and case report forms were sent to the central review system and independently reviewed by four radiologists. All anonymized data were randomly allocated into two groups (groups A and B), which were read by two independent readers. True absence of tumor was defined as pathologic absence of tumor for resected lesions and no in situ recurrence within 1 year after surgery for lesions left unresected at each 3-month follow-up contrast-enhanced CT. Positive predictive values for absence of tumor and for residual tumor on contrast-enhanced CT and EOB MR images were compared by using a generalized estimating equation.
Results: Among 393 CRLMs, the positive predictive value for absence of tumor on EOB MR images (78.0%; 95% confidence interval [CI]: 63.68%, 87.74%) was significantly higher than that on contrast-enhanced CT scans (35.2%; 95% CI: 25.11%, 46.79%; P < .001). The positive predictive value for residual tumor on CT scans (86.0%; 95% CI: 78.61%, 91.16%) was higher than that on EOB MR images (83.8%; 95% CI: 77.50%, 88.67%) without statistical significance (P = .330).
Conclusion: EOB MR imaging was superior to contrast-enhanced CT imaging for assessment of disappearing CRLMs after chemotherapy. © RSNA, 2017 Online supplemental material is available for this article.