Use of Liver Magnetic Resonance Imaging After Standard Staging Abdominopelvic Computed Tomography to Evaluate Newly Diagnosed Colorectal Cancer Patients. Issue 3 (March 2015)

• Record Type: Journal Article
• Authors: Han, Kichang; Park, Seong Ho; Kim, Kyung Won; Kim, Hyoung Jung; Lee, Seung Soo; Kim, Jin Cheon; Yu, Chang Sik; Lim, Seok-Byung; Joo, Yo-Sub; Kim, Ah Young; Ha, Hyun Kwon
• Is Part Of: Annals of surgery. Volume 261:Issue 3(2015:Mar.)
• Publication Date: 2015-03
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1097/SLA.0000000000000708
• Languages: English
• ISSNs: 0003-4932

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective:</title> <p>To investigate the impact of liver magnetic resonance imaging (MRI) in staging evaluation of newly diagnosed colorectal cancer patients.</p> </sec> <sec> <title>Background:</title> <p>No clear guidelines regarding how to use liver MRI in evaluating newly diagnosed colorectal cancer.</p> </sec> <sec> <title>Methods:</title> <p>We included 863 adults who had newly diagnosed colorectal cancer without concomitant malignancies and received portal-phase contrast-enhanced abdominopelvic computed tomography (CT). Patients who had diminutive indeterminate hypoattenuating ["too-small-to-characterize" (TSTC)] hepatic lesions without other suspicious/indeterminate findings (TSTC-liver-on-CT), metastasis-negative hepatic findings (negative-liver-on-CT), and hepatic lesions suspicious or indeterminate for metastasis excluding TSTC lesions as seen on CT were identified. Per-patient rate of hepatic metastasis unsuspected by CT and the diagnostic yield of liver MRI for such lesions were assessed.</p> </sec> <sec> <title>Results:</title> <p>There were 261 TSTC-liver-on-CT patients, 464 negative-liver-on-CT patients, and 138 patients with suspicious hepatic findings on CT. Among TSTC-liver-on-CT patients, the rate of hepatic metastasis was 2.2% (5/230, excluding patients without follow-up) and the yield of liver MRI was 3% (3/96). Negative-liver-on-CT patients gave the MRI yield of 0% (0/94). Among negative-liver-on-CT patients, the rate of hepatic metastasis discovered within 6 months of curative surgery was 1.1% (4/350, excluding patients without follow-up) when the liver was cleared by negative CT alone and 2% (2/88, excluding patients without follow-up) when cleared also by negative MRI (<italic>P</italic> = 0.347). Among the patients who had suspicious hepatic findings on CT, the MRI yield was 25% (19/77).</p> </sec> <sec> <title>Conclusions:</title> <p>The diagnostic yield of liver MRI for hepatic metastasis was very low in newly diagnosed colorectal cancer patients who showed TSTC hepatic lesions or metastasis-negative hepatic findings on CT. Staging liver MRI is likely unnecessary for them.</p> </sec> </abstract>