Skip to main content

Advertisement

SpringerLink
Log in

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

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

CEA:

Carcinoembryonic antigen

IPTW:

Inverse probability of treatment weighting

PS:

Propensity score

RFA:

Radiofrequency ablation

sCLM:

Synchronous liver metastasis of colon cancer

References

  1. Leporrier J, Maurel J, Chiche L, Bara S, Segol P, Launoy G (2006) A population-based study of the incidence, management and prognosis of hepatic metastases from colorectal cancer. Br J Surg 93:465–474

    Article  CAS  Google Scholar 

  2. Manfredi S, Lepage C, Hatem C, Coatmeur O, Faivre J, Bouvier AM (2006) Epidemiology and management of liver metastases from colorectal cancer. Ann Surg 244:254–259

    Article  Google Scholar 

  3. Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH (1999) Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 230:309–318 discussion 318-321

    Article  CAS  Google Scholar 

  4. Iwatsuki S, Dvorchik I, Madariaga JR et al (1999) Hepatic resection for metastatic colorectal adenocarcinoma: a proposal of a prognostic scoring system. J Am Coll Surg 189:291–299

    Article  CAS  Google Scholar 

  5. National Comprehensive Cancer Network (2015) Clinical practice guidelines in oncology, colon cancer, Version 3. https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf. Accessed 14 Mar 2018

  6. Van Cutsem E, Cervantes A, Nordlinger B, Arnold D, Group EGW (2014) Metastatic colorectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 25:iii1–iii9

    Article  Google Scholar 

  7. Chen L, Zhang J, Zhang L et al (2012) Meta-analysis of gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging for the detection of liver metastases. PLoS One 7:e48681

    Article  CAS  Google Scholar 

  8. Bipat S, van Leeuwen MS, Comans EF et al (2005) Colorectal liver metastases: CT, MR imaging, and PET for diagnosis—meta-analysis. Radiology 237:123–131

    Article  Google Scholar 

  9. Vreugdenburg TD, Ma N, Duncan JK, Riitano D, Cameron AL, Maddern GJ (2016) Comparative diagnostic accuracy of hepatocyte-specific gadoxetic acid (Gd-EOB-DTPA) enhanced MR imaging and contrast enhanced CT for the detection of liver metastases: a systematic review and meta-analysis. Int J Colorectal Dis 31:1739–1749

    Article  Google Scholar 

  10. Niekel MC, Bipat S, Stoker J (2010) Diagnostic imaging of colorectal liver metastases with CT, MR imaging, FDG PET, and/or FDG PET/CT: a meta-analysis of prospective studies including patients who have not previously undergone treatment. Radiology 257:674–684

    Article  Google Scholar 

  11. Seo HJ, Kim MJ, Lee JD, Chung WS, Kim YE (2011) Gadoxetate disodium-enhanced magnetic resonance imaging versus contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography for the detection of colorectal liver metastases. Invest Radiol 46:548–555

    Article  CAS  Google Scholar 

  12. Kim HJ, Lee SS, Byun JH et al (2015) Incremental value of liver MR imaging in patients with potentially curable colorectal hepatic metastasis detected at CT: a prospective comparison of diffusion-weighted imaging, gadoxetic acid-enhanced MR imaging, and a combination of both MR techniques. Radiology 274:712–722

    Article  Google Scholar 

  13. Sofue K, Tsurusaki M, Tokue H, Arai Y, Sugimura K (2011) Gd-EOB-DTPA-enhanced 3.0 T MR imaging: quantitative and qualitative comparison of hepatocyte-phase images obtained 10 min and 20 min after injection for the detection of liver metastases from colorectal carcinoma. Eur Radiol 21:2336–2343

    Article  Google Scholar 

  14. Tsurusaki M, Sofue K, Murakami T (2016) Current evidence for the diagnostic value of gadoxetic acid-enhanced magnetic resonance imaging for liver metastasis. Hepatol Res 46:853–861

    Article  CAS  Google Scholar 

  15. Cho JY, Lee YJ, Han HS et al (2015) Role of gadoxetic acid-enhanced magnetic resonance imaging in the preoperative evaluation of small hepatic lesions in patients with colorectal cancer. World J Surg 39:1161–1166

    Article  Google Scholar 

  16. Kim HD, Lim YS, Han S et al (2015) Evaluation of early-stage hepatocellular carcinoma by magnetic resonance imaging with gadoxetic acid detects additional lesions and increases overall survival. Gastroenterology 148:1371–1382

    Article  CAS  Google Scholar 

  17. Jeon SK, Lee JM, Joo I et al (2018) Magnetic resonance with diffusion-weighted imaging improves assessment of focal liver lesions in patients with potentially resectable pancreatic cancer on CT. Eur Radiol. https://doi.org/10.1007/s00330-017-5258-1

    Article  Google Scholar 

  18. Mekenkamp LJ, Koopman M, Teerenstra S et al (2010) Clinicopathological features and outcome in advanced colorectal cancer patients with synchronous vs metachronous metastases. Br J Cancer 103:159–164

    Article  CAS  Google Scholar 

  19. Siriwardena AK, Mason JM, Mullamitha S, Hancock HC, Jegatheeswaran S (2014) Management of colorectal cancer presenting with synchronous liver metastases. Nat Rev Clin Oncol 11:446–459

    Article  CAS  Google Scholar 

  20. Zech CJ, Korpraphong P, Huppertz A et al (2014) Randomized multicentre trial of gadoxetic acid-enhanced MRI versus conventional MRI or CT in the staging of colorectal cancer liver metastases. Br J Surg 101:613–621

    Article  CAS  Google Scholar 

  21. Tanaka M, Kishi Y, Esaki M et al (2016) Feasibility of routine application of gadoxetic acid-enhanced MRI in combination with diffusion-weighted MRI for the preoperative evaluation of colorectal liver metastases. Ann Surg Oncol 23:3991–3998

    Article  Google Scholar 

Download references

Funding

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

Author information

Authors and Affiliations

  1. Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea

    Cherry Kim, So Yeon Kim, Seung Soo Lee, Seong Ho Park & Moon-Gyu Lee

  2. Department of Radiology, Ansan Hospital, Korea University College of Medicine, 516, Gojan 1-dong, Danwon-gu, Ansan-si, 15355, Gyeonggi, Korea

    Cherry Kim

  3. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea

    Min-Ju Kim

  4. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea

    Yong Sik Yoon, Chan Wook Kim & Jae Hoon Lee

  5. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea

    Kyu-pyo Kim

Authors
  1. Cherry Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. So Yeon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Min-Ju Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yong Sik Yoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chan Wook Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jae Hoon Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kyu-pyo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Seung Soo Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Seong Ho Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Moon-Gyu Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to So Yeon Kim.

Ethics declarations

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

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, C., Kim, S.Y., Kim, MJ. et al. Clinical impact of preoperative liver MRI in the evaluation of synchronous liver metastasis of colon cancer. Eur Radiol 28, 4234–4242 (2018). https://doi.org/10.1007/s00330-018-5422-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-018-5422-2

Keywords

Search

Navigation