Skip to main content

Advertisement

SpringerLink
Log in

Detection and characterisation of focal liver lesions in colorectal carcinoma patients: comparison of diffusion-weighted and Gd-EOB-DTPA enhanced MR imaging

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To compare diffusion-weighted imaging (DWI) and Gd-EOB-DTPA-enhanced magnetic resonance (MR) imaging for the detection and characterisation of focal liver lesions (FLLs) in patients with colorectal carcinoma.

Methods

Seventy-three patients underwent MR imaging including echoplanar DWI (MR-DWI) and dynamic (MR-Dyn) and hepatobiliary phase (MR-Late) Gd-EOB-DTPA-enhanced images. Two blinded readers independently reviewed 5 different image sets using a 5-point confidence scale. Accuracy was assessed by the area (Az) under the receiver operating characteristic curve, and sensitivity and specificity were calculated.

Results

A total of 332 FLLs were evaluated. Detection rates were significantly higher for MR-Late images (94.4% for benign and 100% for malignant lesions) compared with MR-DWI (78.3% and 97.5%) and MR-Dyn images (81.5% and 89.9%). Accuracy was 0.82, 0.76 and 0.89 for MR-DWI, MR-Dyn and MR-Late images while sensitivity was 0.98, 0.87 and 0.95, respectively. For characterisation of subcentimetre lesions sensitivity was highest for MR-DWI (0.92). Combined reading of unenhanced and contrast-enhanced images had an identical high accuracy of 0.98.

Conclusion

Late-phase Gd-EOB-DTPA-enhanced images were superior for the detection of FLLs, while DWIs were most valuable for the identification of particularly small metastases. Combined interpretation of unenhanced images resulted in precise characterisation of FLLs.

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.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Garden OJ, Rees M, Poston GJ, Mirza D, Saunders M, Ledermann J, Primrose JN, Parks RW (2006) Guidelines for resection of colorectal cancer liver metastases. Gut 55(Suppl 3):iii1–iii8

    Article  PubMed  Google Scholar 

  2. Steele G Jr, Ravikumar TS (1989) Resection of hepatic metastases from colorectal cancer. Biologic perspective. Ann Surg 210:127–138

    Article  PubMed  Google Scholar 

  3. Namkung S, Zech CJ, Helmberger T, Reiser MF, Schoenberg SO (2007) Superparamagnetic iron oxide (SPIO)-enhanced liver MRI with ferucarbotran: efficacy for characterization of focal liver lesions. J Magn Reson Imaging 25:755–765

    Article  PubMed  Google Scholar 

  4. Hammerstingl R, Huppertz A, Breuer J, Balzer T, Blakeborough A, Carter R, Fuste LC, Heinz-Peer G, Judmaier W, Laniado M, Manfredi RM, Mathieu DG, Muller D, Mortele K, Reimer P, Reiser MF, Robinson PJ, Shamsi K, Strotzer M, Taupitz M, Tombach B, Valeri G, van Beers BE, Vogl TJ (2008) Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions. Eur Radiol 18:457–467

    Article  PubMed  Google Scholar 

  5. Hammerstingl R, Zangos S, Schwarz W, Rosen T, Bechstein WO, Balzer T, Vogl TJ (2002) Contrast-enhanced MRI of focal liver tumors using a hepatobiliary MR contrast agent: detection and differential diagnosis using Gd-EOB-DTPA-enhanced versus Gd-DTPA-enhanced MRI in the same patient. Acad Radiol 9(Suppl 1):S119–S120

    Article  PubMed  Google Scholar 

  6. Ward J (2006) New MR techniques for the detection of liver metastases. Cancer Imaging 6:33–42

    Article  PubMed  CAS  Google Scholar 

  7. Tanimoto A, Lee JM, Murakami T, Huppertz A, Kudo M, Grazioli L (2009) Consensus report of the 2nd International Forum for Liver MRI. Eur Radiol 19(Suppl 5):S975–S989

    Article  PubMed  Google Scholar 

  8. Huppertz A, Balzer T, Blakeborough A, Breuer J, Giovagnoni A, Heinz-Peer G, Laniado M, Manfredi RM, Mathieu DG, Mueller D, Reimer P, Robinson PJ, Strotzer M, Taupitz M, Vogl TJ (2004) Improved detection of focal liver lesions at MR imaging: multicenter comparison of gadoxetic acid-enhanced MR images with intraoperative findings. Radiology 230:266–275

    Article  PubMed  Google Scholar 

  9. Zech CJ, Herrmann KA, Reiser MF, Schoenberg SO (2007) MR imaging in patients with suspected liver metastases: value of liver-specific contrast agent Gd-EOB-DTPA. Magn Reson Med Sci 6:43–52

    Article  PubMed  Google Scholar 

  10. Reimer P, Rummeny EJ, Daldrup HE, Hesse T, Balzer T, Tombach B, Peters PE (1997) Enhancement characteristics of liver metastases, hepatocellular carcinomas, and hemangiomas with Gd-EOB-DTPA: preliminary results with dynamic MR imaging. Eur Radiol 7:275–280

    Article  PubMed  CAS  Google Scholar 

  11. Stern W, Schick F, Kopp AF, Reimer P, Shamsi K, Claussen CD, Laniado M (2000) Dynamic MR imaging of liver metastases with Gd-EOB-DTPA. Acta Radiol 41:255–262

    Article  PubMed  CAS  Google Scholar 

  12. Asbach P, Warmuth C, Stemmer A, Rief M, Huppertz A, Hamm B, Taupitz M, Klessen C (2008) High spatial resolution T1-weighted MR imaging of liver and biliary tract during uptake phase of a hepatocyte-specific contrast medium. Invest Radiol 43:809–815

    Article  PubMed  Google Scholar 

  13. Le Bihan D (1991) Molecular diffusion nuclear magnetic resonance imaging. Magn Reson Q 7:1–30

    PubMed  Google Scholar 

  14. Koh DM, Brown G, Riddell AM, Scurr E, Collins DJ, Allen SD, Chau I, Cunningham D, deSouza NM, Leach MO, Husband JE (2008) Detection of colorectal hepatic metastases using MnDPDP MR imaging and diffusion-weighted imaging (DWI) alone and in combination. Eur Radiol 18:903–910

    Article  PubMed  CAS  Google Scholar 

  15. Bruegel M, Gaa J, Waldt S, Woertler K, Holzapfel K, Kiefer B, Rummeny EJ (2008) Diagnosis of hepatic metastasis: comparison of respiration-triggered diffusion-weighted echo-planar MRI and five t2-weighted turbo spin-echo sequences. AJR Am J Roentgenol 191:1421–1429

    Article  PubMed  Google Scholar 

  16. Gourtsoyianni S, Papanikolaou N, Yarmenitis S, Maris T, Karantanas A, Gourtsoyiannis N (2008) Respiratory gated diffusion-weighted imaging of the liver: value of apparent diffusion coefficient measurements in the differentiation between most commonly encountered benign and malignant focal liver lesions. Eur Radiol 18:486–492

    Article  PubMed  Google Scholar 

  17. Nasu K, Kuroki Y, Nawano S, Kuroki S, Tsukamoto T, Yamamoto S, Motoori K, Ueda T (2006) Hepatic metastases: diffusion-weighted sensitivity-encoding versus SPIO-enhanced MR imaging. Radiology 239:122–130

    Article  PubMed  Google Scholar 

  18. Parikh T, Drew SJ, Lee VS, Wong S, Hecht EM, Babb JS, Taouli B (2008) Focal liver lesion detection and characterization with diffusion-weighted MR imaging: comparison with standard breath-hold T2-weighted imaging. Radiology 246:812–822

    Article  PubMed  Google Scholar 

  19. Hardie AD, Naik M, Hecht EM, Chandarana H, Mannelli L, Babb JS, Taouli B (2010) Diagnosis of liver metastases: value of diffusion-weighted MRI compared with gadolinium-enhanced MRI. Eur Radio l20:1431–1441

    Article  Google Scholar 

  20. Padhani AR, Liu G, Koh DM, Chenevert TL, Thoeny HC, Takahara T, Dzik-Jurasz A, Ross BD, Van Cauteren M, Collins D, Hammoud DA, Rustin GJ, Taouli B, Choyke PL (2009) Diffusion-weighted magnetic resonance imaging as a cancer biomarker: consensus and recommendations. Neoplasia 11:102–125

    PubMed  CAS  Google Scholar 

  21. Danet IM, Semelka RC, Leonardou P, Braga L, Vaidean G, Woosley JT, Kanematsu M (2003) Spectrum of MRI appearances of untreated metastases of the liver. AJR Am J Roentgenol 181:809–817

    PubMed  Google Scholar 

  22. Ba-Ssalamah A, Uffmann M, Saini S, Bastati N, Herold C, Schima W (2009) Clinical value of MRI liver-specific contrast agents: a tailored examination for a confident non-invasive diagnosis of focal liver lesions. Eur Radiol 19:342–357

    Article  PubMed  Google Scholar 

  23. Quinn SF, Benjamin GG (1992) Hepatic cavernous hemangiomas: simple diagnostic sign with dynamic bolus CT. Radiology 182:545–548

    PubMed  CAS  Google Scholar 

  24. Semelka RC, Brown ED, Ascher SM, Patt RH, Bagley AS, Li W, Edelman RR, Shoenut JP, Brown JJ (1994) Hepatic hemangiomas: a multi-institutional study of appearance on T2-weighted and serial gadolinium-enhanced gradient-echo MR images. Radiology 192:401–406

    PubMed  CAS  Google Scholar 

  25. Bluemke DA, Sahani D, Amendola M, Balzer T, Breuer J, Brown JJ, Casalino DD, Davis PL, Francis IR, Krinsky G, Lee FT Jr, Lu D, Paulson EK, Schwartz LH, Siegelman ES, Small WC, Weber TM, Welber A, Shamsi K (2005) Efficacy and safety of MR imaging with liver-specific contrast agent: U.S. multicenter phase III study. Radiology 237:89–98

    Article  PubMed  Google Scholar 

  26. Vogl TJ, Kummel S, Hammerstingl R, Schellenbeck M, Schumacher G, Balzer T, Schwarz W, Muller PK, Bechstein WO, Mack MG, Sollner O, Felix R (1996) Liver tumors: comparison of MR imaging with Gd-EOB-DTPA and Gd-DTPA. Radiology 200:59–67

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany

    D. Löwenthal, M. Zeile, W. Y. Lim, C. Wybranski, F. Fischbach, G. Wieners, M. Pech, J. Ricke & O. Dudeck

  2. Institute of Biometry and Medical Informatics, Otto-von-Guericke University, Leipziger Strasse 44, 39120, Magdeburg, Germany

    S. Kropf

Authors
  1. D. Löwenthal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Zeile
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. W. Y. Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Wybranski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Fischbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Wieners
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Pech
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S. Kropf
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. J. Ricke
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. O. Dudeck
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to O. Dudeck.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Löwenthal, D., Zeile, M., Lim, W.Y. et al. Detection and characterisation of focal liver lesions in colorectal carcinoma patients: comparison of diffusion-weighted and Gd-EOB-DTPA enhanced MR imaging. Eur Radiol 21, 832–840 (2011). https://doi.org/10.1007/s00330-010-1977-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-010-1977-2

Keywords

Search

Navigation