Liver Metastases in Candidates for Hepatic Resection: Comparison of Helical CT and Gadolinium- and SPIO-enhanced MR Imaging

Abstract

Accuracy for gadolinium-enhanced MR imaging and SPIO-enhanced MR imaging was similar. Both techniques were significantly more accurate than CT.

Focal Liver Lesions

“…These liver-specific agents are taken up into hepatocytes to varying extent (gadobenate dimeglumine 4-5%; gadoxetic acid ~50%), resulting in avid T1 enhancement of the liver parenchyma in the hepatobiliary a b phase, which is performed at 20 min for gadoxetic acid and about 1-2 h for gadobenate dimeglumine after contrast administration. Liver-specific contrast agents have been shown to improve the detection of liver metastases [23][24][25][26], especially when used in combination with diffusion-weighted MR imaging.…”

Preoperative Imaging in Colorectal Liver Metastases: Current Practices

“…Early studies that compared different MR modalities directly, specifically Gadolinium and SPIO, identified no difference in accuracy. When these modalities are compared to CT, both MR techniques provide superior accuracy that is more sensitive for lesions \1 cm in size [20]. As experience with hepatic-specific contrast agents evolves, these agents result in improving lesion identification.…”

“…Accurate detection and localization of all metastatic disease is essential for determining which patients have the potential to undergo a curative R0 resection. Superparamagnetic iron oxide has been shown to be very sensitive for detecting sub-centimeter colorectal hepatic metastases [20]. A recent prospective study evaluating the sensitivity of SPIO-MRI using early contrastenhancing T1 imaging, which results in the creation of isointense liver/vasculature background in which liver metastases stand out, resulted in a detection rate of 77 % in patients receiving neoadjuvant therapy versus 87 % in patients who did not receive chemotherapy [26].…”

Laparoscopic Liver Surgery

“…The technique is very sensitive to respiratory artefact and this can limit its resolution in certain patients who are unable to hold their breath for a sufficient length of time. Contrast agents such as gadolinium and the liver specific super magnetic iron oxide result in very high sensitivities in diagnosing small (less than 1 cm) liver metastases 57 and differentiating between potentially malignant and benign liver lesions (e.g. FNH, adenoma etc).…”