Diagnostic accuracy of rim and segmental MRI enhancement of colorectal hepatic metastasis after administration of mangafodipir trisodium.

OBJECTIVE The purpose of this study was to determine the diagnostic accuracy of rim and segmental MRI enhancement of hepatic metastasis of colorectal cancer after administration of mangafodipir trisodium (MnDPDP). SUBJECTS AND METHODS Sixty-one patients with a potentially resectable hepatic metastasis of colorectal cancer consecutively underwent breath-hold T1-weighted MRI in the axial and coronal planes 30 minutes and 24 hours after administration of MnDPDP. For each lesion, the presence or absence of rim enhancement and segmental enhancement 30 minutes and 24 hours after contrast administration was recorded. These features were evaluated separately for lesions 10 mm in diameter or larger and lesions smaller than 10 mm. The nature of each lesion was determined at histopathologic examination (n = 29) and on follow-up imaging (n = 32). RESULTS Two hundred thirty lesions were identified at MRI: 210 lesions were metastatic, and 20 were benign. Rim enhancement was observed around 22 of 210 (10%) of the metastatic lesions at 30 minutes and 199 of 210 (95%) of metastatic lesions at 24 hours. Rim enhancement at 24 hours had 94.8% (95% CI, 91.8-97.8%) sensitivity, 90.0% (68.3-98.8%) specificity, 99.0% (97.6-100%) positive predictive value, 62.1% (42.3-79.3%) negative predictive value, and 94.3% (91.4-97.3%) diagnostic accuracy for metastasis. Segmental enhancement was infrequently seen (34/210; 16%) at 24 hours but had 100% (89.7-100%) positive predictive value for metastasis. CONCLUSION Rim and segmental enhancement at MRI 24 hours after MnDPDP administration enabled accurate characterization of hepatic colorectal metastasis. These features may aid in preoperative mapping of hepatic tumor burden and disease distribution in patients with colorectal cancer.

[1]  E. Scurr,et al.  Detection of colorectal hepatic metastases using MnDPDP MR imaging and diffusion-weighted imaging (DWI) alone and in combination , 2008, European Radiology.

[2]  Gina Brown,et al.  Imaging of liver metastases (CT scan, MRI, PET scan) , 2007 .

[3]  D. Sahani,et al.  Detection of liver metastases from adenocarcinoma of the colon and pancreas: comparison of mangafodipir trisodium-enhanced liver MRI and whole-body FDG PET. , 2005, AJR. American journal of roentgenology.

[4]  G. Poston.  Surgical strategies for colorectal liver metastases. , 2004, Surgical oncology.

[5]  S. Park,et al.  Small (, 2004, AJR. American journal of roentgenology.

[6]  F. Pilleul,et al.  [Detection of liver metastases in colorectal cancer on chemotherapy. Comparative study between MRI with teslascan and computed tomography with intravenous contrast media]. , 2004, Journal de radiologie.

[7]  D. Fraker,et al.  Combined 5-Fluorouracil/Systemic Interferon-β Gene Therapy Results in Long-Term Survival in Mice with Established Colorectal Liver Metastases , 2004, Clinical Cancer Research.

[8]  C. Bartolozzi,et al.  Detection of colorectal liver metastases: a prospective multicenter trial comparing unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT , 2004, European Radiology.

[9]  B. Davidson,et al.  Strategies to Increase the Resectability of Liver Metastases from Colorectal Cancer , 2003, Digestive Surgery.

[10]  J. Healy,et al.  MnDPDP enhanced magnetic resonance imaging of focal liver lesions. , 2002, Clinical radiology.

[11]  M. Haider,et al.  Multi-detector row helical CT in preoperative assessment of small (< or = 1.5 cm) liver metastases: is thinner collimation better? , 2002, Radiology.

[12]  Michael A. Choti,et al.  Trends in Long-Term Survival Following Liver Resection for Hepatic Colorectal Metastases , 2002, Annals of surgery.

[13]  E. Rummeny,et al.  MRI characteristics in focal hepatic disease before and after administration of MnDPDP: discriminant analysis as a diagnostic tool , 2002, European Radiology.

[14]  W. Lees,et al.  Neo-adjuvant therapy improves resectability rates for colorectal liver metastases. , 2001, Annals of the Royal College of Surgeons of England.

[15]  M. van Glabbeke,et al.  New guidelines to evaluate the response to treatment in solid tumors , 2000, Journal of the National Cancer Institute.

[16]  S. S. Yoon,et al.  Surgical treatment and other regional treatments for colorectal cancer liver metastases. , 1999, The oncologist.

[17]  L. Schwartz,et al.  Prevalence and importance of small hepatic lesions found at CT in patients with cancer. , 1999, Radiology.

[18]  S. McGill,et al.  Uptake of mangafodipir trisodium in liver metastases from endocrine tumors , 1998, Journal of magnetic resonance imaging : JMRI.

[19]  S. Lippman,et al.  Role of paclitaxel, ifosfamide, and cisplatin in patients with recurrent or metastatic squamous cell carcinoma of the head and neck. , 1998, Seminars in oncology.

[20]  C. Wang,et al.  Mangafodipir trisodium (MnDPDP)-enhanced magnetic resonance imaging of the liver and pancreas. , 1998, Acta radiologica. Supplementum.

[21]  H. Ahlström,et al.  MR imaging properties and pharmacokinetics of MnDPDP in healthy volunteers , 1997, Acta radiologica.

[22]  N. Heaton,et al.  MnDPDP-enhanced MR imaging of the liver , 1997, Acta radiologica.

[23]  M. Rees,et al.  Late results justify resection for multiple hepatic metastases from colorectal cancer , 1997, The British journal of surgery.

[24]  A Pfefferbaum,et al.  Hepatobiliary MR imaging: first human experience with MnDPDP. , 1991, Radiology.

[25]  G. Elizondo,et al.  Preclinical evaluation of MnDPDP: new paramagnetic hepatobiliary contrast agent for MR imaging. , 1991, Radiology.

[26]  J. Ranstam,et al.  Determinants of survival in liver resection for colorectal secondaries , 1986, The British journal of surgery.