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2 cm) Hepatic Lesions in Colorectal Cancer Patients: Detection and Characterization on Mangafodipir Trisodium–Enhanced MRI
1 All authors: Department of Radiology, University of Ulsan-Asan Medical Center, 388-1, Pungnap-dong, Songpa-ku, Seoul 138-736, Korea.
OBJECTIVE. The purpose of this study was to evaluate whether
mangafodipir trisodium (MnDPDP)–enhanced MRI improves the detection and
characterization of small (
2 cm) hepatic lesions in patients with
colorectal carcinoma, compared with helical CT.
SUBJECTS AND METHODS. Sixty-nine patients who had or were suspected
of having focal liver lesions underwent helical CT and MnDPDP-enhanced MRI and
constituted the study population. Two experienced radiologists independently
reviewed CT and MR images for the number of hepatic lesions seen and whether
the lesion appeared to be benign or metastatic; their interpretations were
correlated with the reference diagnoses, including histopathologic diagnoses
in 35 patients. The lesions were categorized as small ( 2.0 cm in
diameter) or large (> 2.0 cm). The differences between MnDPDP-enhanced MRI
and helical CT with regard to the detection rates for hepatic lesions and
metastases and with regard to the false-positive rates for hepatic metastases
were analyzed using the McNemar test. The performances of MnDPDP-enhanced MRI
and helical CT in indicating metastases of focal liver lesions were analyzed
using receiver operating characteristic curves.
RESULTS. No statistically significant differences were seen between MnDPDP-enhanced MRI and helical CT in the detection of all hepatic lesions (p = 0.383) and small lesions (p = 0.210). However, concerning the differentiation between benign and metastatic lesions, MnDPDP-enhanced MRI was superior to helical CT both for all hepatic lesions (p = 0.023) and for small lesions (p = 0.015), and remained better when the analyses were restricted to patients with histopathologic confirmation (p = 0.023 for both). MnDPDP-enhanced MRI changed the diagnosis of hepatic metastasis in nine (13.0%) of 69 patients. Of 12 metastases that were found on MnDPDP-enhanced MRI and missed on helical CT, 11 lesions (91.7%) were small. MnDPDP-enhanced MRI showed a significantly greater detection rate than helical CT for small hepatic metastases (p = 0.022). MnDPDP-enhanced MRI was better when the analyses were restricted to patients with histopathologic confirmation (p = 0.043).
CONCLUSION. Although MnDPDP-enhanced MRI is equal to helical CT in detection of both all hepatic lesions and small lesions in patients with colorectal carcinoma, it is superior to CT in characterization of the lesions.
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