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European Radiology

, Volume 28, Issue 10, pp 4234–4242 | Cite as

Clinical impact of preoperative liver MRI in the evaluation of synchronous liver metastasis of colon cancer

  • Cherry Kim
  • So Yeon Kim
  • Min-Ju Kim
  • Yong Sik Yoon
  • Chan Wook Kim
  • Jae Hoon Lee
  • Kyu-pyo Kim
  • Seung Soo Lee
  • Seong Ho Park
  • Moon-Gyu Lee
Gastrointestinal
  • 234 Downloads

Abstract

Objectives

To investigate whether additional MRI including gadoxetic acid enhancement is associated with survival rate (SR) in patients with synchronous liver metastasis of colon cancer (sCLM), compared with patients assessed only with CT.

Methods

Fifty-two patients underwent only CT (CT group) and 65 underwent additional MRI (CT+MRI group) for preoperative work-up of sCLM. In the CT+MRI group, the discrepancy between CT and MRI was analyzed. The 5-year SR was compared between the groups, and affecting factors were investigated. The inverse probability treatment weighting analysis (IPTW) adjusted by propensity scores was performed.

Results

In the CT+MRI group, 44 (67.7%) showed a discrepancy in the number of sCLMs between CT and MRI. MRI detected 39 additional sCLMs initially missed on CT in 26 patients. The number of detected sCLMs was better correlated with the pathologic findings in the CT+MRI group than in the CT group (p = 0.008). The estimated 5-year SR in the CT+MRI group was 70.8%, while that in the CT group was 48.1%. On adjusted multivariate analyses after the IPTW, the CT+MRI group showed a significantly lower risk of overall mortality than the CT group.

Conclusion

Additional preoperative evaluation by MRI allowed us to more precisely detect sCLM and was associated with a better SR.

Key Points

• CT+MRI group showed significantly higher 5-year survival rates than CT group.

• CT+MRI group was an independent prognostic factor of overall mortality.

• MRI facilitates more accurate detection and better lesion characterization.

• MRI selected better candidates for curative treatment.

• The benefits of MRI were reflected by better survival.

Keywords

Colonic neoplasms Neoplasm metastasis Liver Magnetic resonance imaging Multidetector computed tomography 

Abbreviations

CEA

Carcinoembryonic antigen

IPTW

Inverse probability of treatment weighting

PS

Propensity score

RFA

Radiofrequency ablation

sCLM

Synchronous liver metastasis of colon cancer

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is So Yeon Kim.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the institutional review board.

Ethical approval

Institutional review board approval was obtained.

Methodology

• retrospective

• case-control study

• performed at one institution

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Cherry Kim
    • 1
    • 2
  • So Yeon Kim
    • 1
  • Min-Ju Kim
    • 3
  • Yong Sik Yoon
    • 4
  • Chan Wook Kim
    • 4
  • Jae Hoon Lee
    • 4
  • Kyu-pyo Kim
    • 5
  • Seung Soo Lee
    • 1
  • Seong Ho Park
    • 1
  • Moon-Gyu Lee
    • 1
  1. 1.Department of Radiology and the Research Institute of RadiologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulKorea
  2. 2.Department of RadiologyAnsan Hospital, Korea University College of MedicineAnsan-siKorea
  3. 3.Department of Clinical Epidemiology and BiostatisticsAsan Medical Center, University of Ulsan College of MedicineSeoulKorea
  4. 4.Department of SurgeryAsan Medical Center, University of Ulsan College of MedicineSeoulKorea
  5. 5.Department of OncologyAsan Medical Center, University of Ulsan College of MedicineSeoulKorea

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