D M Riviere1, E J M van Geenen2, B M van der Kolk3, I D Nagtegaal4, S A Radema5, C J H M van Laarhoven3, J J Hermans6. 1. Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, NL, The Netherlands. 2. Department of Gastroenterology, Radboud University Medical Center, Nijmegen, NL, The Netherlands. 3. Department of Surgery, Radboud University Medical Center, Nijmegen, NL, The Netherlands. 4. Department of Pathology, Radboud University Medical Center, Nijmegen, NL, The Netherlands. 5. Department of Oncology, Radboud University Medical Center, Nijmegen, NL, The Netherlands. 6. Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, NL, The Netherlands. John.Hermans@radboudumc.nl.
Abstract
PURPOSE: To explore the value of gadolinium-enhanced MRI combined with diffusion-weighted MRI (Gd-enhanced MRI with DWI) in addition to contrast-enhanced CT (CECT) for detection of synchronous liver metastases for potentially resectable pancreatic cancer. METHODS: By means of a retrospective cohort study we included patients with potentially resectable pancreatic cancer on CECT, who underwent Gd-enhanced MRI with DWI between January 2012 and December 2016. A single observer evaluated MRI and CT and was blinded to imaging, pathology, and surgery reports. Liver lesions were scored in both modalities, using a 3-point scale: 1-benign, 2-indeterminate, 3- malignant (i.e., metastasis). The primary outcome parameters were the presence of liver metastases on Gd-enhanced MRI with DWI and the sensitivity of Gd-enhanced MRI with DWI for synchronous liver metastases. RESULTS: We included 66 patients (42 men, 24 women; median age 65 years, range 36-82 years). In 19 patients, liver metastases were present, which were confirmed by histopathology (n = 12), 18FDG-PET (n = 6), or surgical inspection (n = 1). Gd-enhanced MRI with DWI showed metastases in 16/19 patients (24%), which resulted in a sensitivity of 84% (95% CI 60-97%). Contrast-enhanced MRI showed 156 and DWI 397 metastases (p = 0.051), and 339 were particularly small (< 5 mm). CONCLUSIONS: In this study, Gd-enhanced MRI with DWI detected synchronous liver metastases in 24% of patients with potentially resectable pancreatic cancer on CECT with a sensitivity of 84%. Diffusion-weighted MRI showed a greater number of metastases than any other sequence, particularly small metastases (< 5 mm).
PURPOSE: To explore the value of gadolinium-enhanced MRI combined with diffusion-weighted MRI (Gd-enhanced MRI with DWI) in addition to contrast-enhanced CT (CECT) for detection of synchronous liver metastases for potentially resectable pancreatic cancer. METHODS: By means of a retrospective cohort study we included patients with potentially resectable pancreatic cancer on CECT, who underwent Gd-enhanced MRI with DWI between January 2012 and December 2016. A single observer evaluated MRI and CT and was blinded to imaging, pathology, and surgery reports. Liver lesions were scored in both modalities, using a 3-point scale: 1-benign, 2-indeterminate, 3- malignant (i.e., metastasis). The primary outcome parameters were the presence of liver metastases on Gd-enhanced MRI with DWI and the sensitivity of Gd-enhanced MRI with DWI for synchronous liver metastases. RESULTS: We included 66 patients (42 men, 24 women; median age 65 years, range 36-82 years). In 19 patients, liver metastases were present, which were confirmed by histopathology (n = 12), 18FDG-PET (n = 6), or surgical inspection (n = 1). Gd-enhanced MRI with DWI showed metastases in 16/19 patients (24%), which resulted in a sensitivity of 84% (95% CI 60-97%). Contrast-enhanced MRI showed 156 and DWI 397 metastases (p = 0.051), and 339 were particularly small (< 5 mm). CONCLUSIONS: In this study, Gd-enhanced MRI with DWI detected synchronous liver metastases in 24% of patients with potentially resectable pancreatic cancer on CECT with a sensitivity of 84%. Diffusion-weighted MRI showed a greater number of metastases than any other sequence, particularly small metastases (< 5 mm).
Authors: Moritz T Winkelmann; Rami Archid; Georg Gohla; Gerald Hefferman; Jens Kübler; Jakob Weiss; Stephan Clasen; Konstantin Nikolaou; Silvio Nadalin; Rüdiger Hoffmann Journal: Cancer Imaging Date: 2020-05-27 Impact factor: 3.909
Authors: G Litjens; D M Rivière; E J M van Geenen; S A Radema; L A A Brosens; M Prokop; C J H M van Laarhoven; J J Hermans Journal: BMC Cancer Date: 2020-08-10 Impact factor: 4.430