Use of liver magnetic resonance imaging after standard staging abdominopelvic computed tomography to evaluate newly diagnosed colorectal cancer patients.
Ann Surg
; 261(3): 480-6, 2015 Mar.
Article
en En
| MEDLINE
| ID: mdl-24866542
ABSTRACT
OBJECTIVE:
To investigate the impact of liver magnetic resonance imaging (MRI) in staging evaluation of newly diagnosed colorectal cancer patients.BACKGROUND:
No clear guidelines regarding how to use liver MRI in evaluating newly diagnosed colorectal cancer.METHODS:
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.RESULTS:
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 (P = 0.347). Among the patients who had suspicious hepatic findings on CT, the MRI yield was 25% (19/77).CONCLUSIONS:
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.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Imagen por Resonancia Magnética
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Neoplasias Colorrectales
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Tomografía Computarizada por Rayos X
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Neoplasias Hepáticas
Tipo de estudio:
Diagnostic_studies
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Guideline
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Observational_studies
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Prognostic_studies
Límite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2015
Tipo del documento:
Article