Abbreviated MRI protocol for colorectal liver metastases: How the radiologist could work in pre surgical setting.

oleh: Vincenza Granata, Roberta Fusco, Antonio Avallone, Antonino Cassata, Raffaele Palaia, Paolo Delrio, Roberta Grassi, Fabiana Tatangelo, Giulia Grazzini, Francesco Izzo, Antonella Petrillo

Format: Article
Diterbitkan: Public Library of Science (PLoS) 2020-01-01

Deskripsi

<h4>Background</h4>MRI is the most reliable imaging modality that allows to assess liver metastases. Our purpose is to compare the per-lesion and per-patient detection rate of gadoxetic acid-(Gd-EOB) enhanced liver MRI and fast MR protocol including Diffusion Weighted Imaging (DWI) and T2-W Fat Suppression sequence in the detection of liver metastasis in pre surgical setting.<h4>Methods</h4>One hundred and eight patients with pathologically proven liver metastases (756 liver metastases) underwent Gd-EOBMRI were enrolled in this study. Three radiologist independently graded the presence of liver lesions on a five-point confidence scale assessed only abbreviated protocol (DWI and sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) fat suppressed sequence) and after an interval of more than 2 weeks the conventional study (all acquired sequences). Per-lesion and per-patient detection rate of metastases were calculated. Weighted ะบ values were used to evaluate inter-reader agreement of the confidence scale regarding the presence of the lesion.<h4>Results</h4>MRI detected 732 liver metastases. All lesions were identified both by conventional study as by abbreviated protocol. In terms of per-lesion detection rate of liver metastasis, all three readers had higher detection rate both with abbreviated protocol and with standard protocol with Gd-EOB (96.8% [732 of 756] vs. 96.5% [730 of 756] for reader 1; 95.8% [725 of 756] vs. 95.2% [720 of 756] for reader 2; 96.5% [730 of 756] vs. 96.5% [730 of 756] for reader 3). Inter-reader agreement of lesions detection rate between the three radiologists was excellent (k range, 0.86-0.98) both for Gd-EOB MRI and for Fast protocol (k range, 0.89-0.99).<h4>Conclusion</h4>Abbreviated protocol showed the same detection rate than conventional study in detection of liver metastases.