Abstract
1822
Objectives Exact knowledge of the presence and regional distribution of hepatic metastases is essential for better patient management and surgical decisions. Our objective was to evaluate the performance of PET/CT and ceMRI in the detection of hepatic metastasis of GI malignancies.
Methods PET/CT and ceMR data were reviewed in 29 pts (median age 60 yrs) (14 colorectal, 8 pancreatic and 6 cholangiocarcinoma) either at staging or restaging. PET/CT was performed within 6 wks of ceMRI. A positive PET is defined as focal increased uptake that exceeds the background liver uptake. Histopathology (n=4) and 12 month follow-up (n=25) were used as gold standard for a lesion-based analyses.
Results PET/CT and ceMRI together showed 39 hepatic lesions. There were 12 equivocal results, 2 on PET/CT and 10 on ceMRI (0.2-1.5 cm). Equivocal findings were evaluated in 3 ways, considering them either as positive or negative and with exclusion from data. These results are displayed in Table. A more specific interpretation of equivocal lesions was achieved by considering them as negative on both tests but with a significant decrease in sensitivity of ceMRI.
Conclusions In the detection of hepatic metastasis of GI cancers, ceMRI is more sensitive than PET/CT with no significant difference in specificity. PET/CT may complement ceMRI, particularly, in the evaluation of equivocal lesions to improve the specificity. Our results appear supportive of future PET/MRI applications in GI malignancies, however, further validation of these findings are warranted in a larger population
*p= 0.125; **p=0.004; §p=0.25 ¶p=0.125
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