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Dynamic contrast-enhanced MRI coupled with a subtraction technique is useful for treatment response evaluation of malignant melanoma hepatic metastasis

 Minsu Lee  ;  Song-Ee Baek  ;  Jieun Moon  ;  Yun Ho Roh  ;  Joon Seok Lim  ;  Mi-Suk Park  ;  Myeong-Jin Kim  ;  Honsoul Kim 
 ONCOTARGET , Vol.7(25) : 38513-38522, 2016 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Contrast Media/therapeutic use* ; Female ; Humans ; Liver Neoplasms/diagnostic imaging* ; Liver Neoplasms/pathology ; Liver Neoplasms/secondary* ; Magnetic Resonance Imaging/methods* ; Male ; Melanoma/diagnostic imaging* ; Melanoma/pathology ; Middle Aged ; Neoplasm Metastasis ; Young Adult
mRECIST ; magnetic resonance imaging ; melanoma liver metastasis ; subtraction technique ; treatment response
PURPOSE: To determine whether contrast-enhanced MRI including subtraction sequences can predict the treatment response of melanoma liver metastasis.

RESULTS: High precontrast T1 signal intensity (SI) of melanoma lesions obscured detection of enhancement after contrast injection. It was impossible to determine whether or not enhancement occurred in the majority of lesions (85.4%, n = 35/41) without including the subtraction technique. Positive enhancement was identified in 14.6% (n = 6/41) of patients without subtraction images, but increased to 68.3% (n = 28/41) by including subtraction images. Follow-up studies determined lesion progression in 34.1% (n = 14/41) of patients. Positive enhancement on the subtraction image (odds ratio = 12.1, P = 0.048) and intermediate high T2 SI (odds ratio = 8.16, P = 0.040) were significantly associated with higher risk of lesion progression.

MATERIALS AND METHODS: Patients who underwent MRI for melanoma liver metastases between January 2007 and February 2015 were enrolled. The study analyzed 41 liver metastases in 15 patients [11 male and four female; median age 56 years (range 21-81)] for size, lesion enhancement with and without subtraction images, and T2 SI. Follow-up imaging studies were used to determine treatment response. Data were analyzed with generalized estimating equations.

CONCLUSIONS: MRI including the subtraction technique is useful for determining the treatment response of melanoma liver metastases. Lesion contrast enhancement and intermediate high T2 SI increased the risk of lesion progression.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Hon Soul(김한솔)
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Baek, Song Ee(백송이) ORCID logo https://orcid.org/0000-0001-8146-2570
Lee, Minsu(이민수)
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
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