Takaaki Ito1, Teiichi Sugiura2, Yukiyasu Okamura2, Yusuke Yamamoto2, Ryo Ashida2, Takeshi Aramaki3, Masahiro Endo3, Katsuhiko Uesaka2. 1. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan. Electronic address: tak.ito@scchr.jp. 2. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan. 3. Division of Diagnostic Radiology, Shizuoka Cancer Center Hospital, Shizuoka, Japan.
Abstract
BACKGROUND: Liver metastases (LMs) are sometimes diagnosed intraoperatively, even when multidetector-row computed tomography (MDCT) reveals no LM in the staging of pancreatic cancer (PC). Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MR imaging) may have a role to play in the detection of LM. METHODS: The present study included a total of 201 patients who underwent an EOB-MR imaging examination before undergoing surgical resection for pancreatic cancer that was determined to be radiologically-resectable by MDCT. Intrahepatic lesions that were considered suspected to be liver metastases following an EOB-MR imaging examination were defined as possible lesions (PLs). All PLs were evaluated by a pathological examination or through close follow-up examinations. The diagnostic ability of EOB-MR imaging was assessed. The predictive factors for liver metastasis were evaluated. RESULTS: Thirty-seven PLs were noted in 17 patients: 31 PLs were true LMs, and six were benign lesions (3 hemangiomas and 3 abscesses). Nine LMs were newly detected during surgery and were not detected by preoperative EOB-MR imaging. The diagnostic ability of EOB-MR imaging was as follows: sensitivity, 77.5%; specificity, 94.7%; positive predictive value, 83.8%; negative predictive value, 92.3%; and accuracy, 90.2%. A multivariate analysis revealed that the presence of PL on EOB-MR imaging was the only independent risk factor for intraoperative liver metastasis (P < 0.001). CONCLUSION: EOB-MR imaging was useful in detecting tiny liver metastases from pancreatic cancer in cases that were determined to be radiologically resectable by MDCT.
BACKGROUND:Liver metastases (LMs) are sometimes diagnosed intraoperatively, even when multidetector-row computed tomography (MDCT) reveals no LM in the staging of pancreatic cancer (PC). Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MR imaging) may have a role to play in the detection of LM. METHODS: The present study included a total of 201 patients who underwent an EOB-MR imaging examination before undergoing surgical resection for pancreatic cancer that was determined to be radiologically-resectable by MDCT. Intrahepatic lesions that were considered suspected to be liver metastases following an EOB-MR imaging examination were defined as possible lesions (PLs). All PLs were evaluated by a pathological examination or through close follow-up examinations. The diagnostic ability of EOB-MR imaging was assessed. The predictive factors for liver metastasis were evaluated. RESULTS: Thirty-seven PLs were noted in 17 patients: 31 PLs were true LMs, and six were benign lesions (3 hemangiomas and 3 abscesses). Nine LMs were newly detected during surgery and were not detected by preoperative EOB-MR imaging. The diagnostic ability of EOB-MR imaging was as follows: sensitivity, 77.5%; specificity, 94.7%; positive predictive value, 83.8%; negative predictive value, 92.3%; and accuracy, 90.2%. A multivariate analysis revealed that the presence of PL on EOB-MR imaging was the only independent risk factor for intraoperative liver metastasis (P < 0.001). CONCLUSION: EOB-MR imaging was useful in detecting tiny liver metastases from pancreatic cancer in cases that were determined to be radiologically resectable by MDCT.
Authors: Guilherme Moura Cunha; Kyle A Hasenstab; Atsushi Higaki; Kang Wang; Timo Delgado; Ryan L Brunsing; Alexandra Schlein; Armin Schwartzman; Albert Hsiao; Claude B Sirlin; Katie J Fowler Journal: Eur J Radiol Date: 2020-01-14 Impact factor: 3.528
Authors: Kartik S Jhaveri; Ali Babaei Jandaghi; Seng Thipphavong; Osvaldo Espin-Garcia; Anna Dodd; Shawn Hutchinson; Trevor W Reichman; Carol-Anne Moulton; Ian D McGilvary; Steven Gallinger Journal: Cancer Imaging Date: 2021-06-30 Impact factor: 3.909