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Use of Imaging to Predict Complete Response of Colorectal Liver Metastases after Chemotherapy: MR Imaging versus CT Imaging

 Min Jung Park  ;  Nurhee Hong  ;  Kyunghwa Han  ;  Min Ju Kim  ;  Yoon Jin Lee  ;  Yang Shin Park  ;  Sung Eun Rha  ;  Sumi Park  ;  Won Jae Lee  ;  Seong Ho Park  ;  Chang Hee Lee  ;  Chung Mo Nam  ;  Chansik An  ;  Hye Jin Kim  ;  Honsoul Kim  ;  Mi-Suk Park 
 RADIOLOGY, Vol.284(2) : 423-431, 2017 
Journal Title
Issue Date
Adult ; Aged ; Catheter Ablation ; Colorectal Neoplasms/pathology* ; Contrast Media ; Female ; Gadolinium DTPA ; Humans ; Liver Neoplasms/diagnostic imaging* ; Liver Neoplasms/drug therapy* ; Liver Neoplasms/secondary* ; Liver Neoplasms/surgery ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/methods* ; Treatment Outcome
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.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hon Soul(김한솔)
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Park, Min Jung(박민정)
An, Chansik(안찬식) ORCID logo https://orcid.org/0000-0002-0484-6658
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