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Comparison of MRI (including SS SE-EPI and SPIO-enhanced MRI) and FDG-PET/CT for the detection of colorectal liver metastases

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Abstract

Fluoro-18-deoxyglucose positron emission tomography computed tomography (FDG-PET/CT) and magnetic resonance imaging (MRI), including unenhanced single-shot spin-echo echo planar imaging (SS SE-EPI) and small paramagnetic iron oxide (SPIO) enhancement, were compared prospectively for detecting colorectal liver metastases. Twenty-four consecutive patients suspected for metastases underwent MRI and FDG-PET/CT. Fourteen patients (58%) had previously received chemotherapy, including seven patients whose chemotherapy was still continuing to within 1 month of the PET/CT study. The mean interval between PET/CT and MRI was 10.2 ± 5.2 days. Histopathology (n = 18) or follow-up imaging (n = 6) were used as reference. Seventy-seven metastases were detected. In nine patients, MRI and PET/CT gave concordant results. Sensitivities for unenhanced SS SE-EPI, MRI without SS SE-EPI and FDG-PET/CT were, respectively, 100% (p = 9 × 10−10 vs PET, p = 8 × 10−3 vs MRI without SS SE-EPI), 90% (p = 2 × 10−7 vs PET) and 60%. PET/CT sensitivity dropped significantly with decreasing size, from 100% in lesions larger than 20 mm (identical to MRI), over 54% in lesions between 10 and 20 mm (p = 3 × 105 versus unenhanced SS SE-EPI), to 32% in lesions under 10 mm (p = 6 × 10−5 versus unenhanced SS SE-EPI). Positive predictive value of PET was 100% (identical to MRI). MRI, particularly unenhanced SS SE-EPI, has good sensitivity and positive predictive value for detecting liver metastases from colorectal carcinoma. Its sensitivity is better than that of FDG-PET/CT, especially for small lesions.

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Authors and Affiliations

  1. Department of Radiology, AZ St.-Jan AV, Ruddershove 10, 8000, Bruges, Belgium

    Kenneth Coenegrachts & Hans Rigauts

  2. Department of Nuclear Medicine, AZ St.-Jan AV, Bruges, Belgium

    Frank De Geeter & Natascha Walgraeve

  3. Philips Medical Systems, Best, The Netherlands

    Leon ter Beek

  4. Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands

    Shandra Bipat & Jaap Stoker

Authors
  1. Kenneth Coenegrachts
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  2. Frank De Geeter
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  3. Leon ter Beek
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  4. Natascha Walgraeve
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  5. Shandra Bipat
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  6. Jaap Stoker
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  7. Hans Rigauts
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Correspondence to Kenneth Coenegrachts.

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Coenegrachts, K., De Geeter, F., ter Beek, L. et al. Comparison of MRI (including SS SE-EPI and SPIO-enhanced MRI) and FDG-PET/CT for the detection of colorectal liver metastases. Eur Radiol 19, 370–379 (2009). https://doi.org/10.1007/s00330-008-1163-y

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  • DOI: https://doi.org/10.1007/s00330-008-1163-y

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