Comparative evaluation of non-contrast MRI versus gadoxetic acid-enhanced abbreviated protocols in detecting colorectal liver metastases
Abstract Purpose This study compares the diagnostic efficacy of non-contrast abbreviated MRI protocols with Gadoxetic acid-enhanced abbreviated MRI for detecting colorectal liver metastasis (CRLM), focusing on lesion characterization and surveillance. Methods Ninety-four patients, including 55 with...
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SpringerOpen
2025-01-01
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| Series: | Insights into Imaging |
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| Online Access: | https://doi.org/10.1186/s13244-024-01886-3 |
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| author | Haoran Dai Cheng Yan Xi Jia Yuyao Xiao Xinyue Liang Chun Yang Kai Liu Mengsu Zeng |
| author_facet | Haoran Dai Cheng Yan Xi Jia Yuyao Xiao Xinyue Liang Chun Yang Kai Liu Mengsu Zeng |
| author_sort | Haoran Dai |
| collection | DOAJ |
| description | Abstract Purpose This study compares the diagnostic efficacy of non-contrast abbreviated MRI protocols with Gadoxetic acid-enhanced abbreviated MRI for detecting colorectal liver metastasis (CRLM), focusing on lesion characterization and surveillance. Methods Ninety-four patients, including 55 with pathologically verified CRLM, were enrolled, totaling 422 lesions (287 metastatic, 135 benign). Two independent readers assessed three MRI protocols per patient: Protocol 1 included non-contrast sequences (T2-weighted turbo spin-echo, T1-weighted Dixon, diffusion-weighted imaging (DWI), and ADC mapping). Protocol 2 included gadoxetic acid enhancement with hepatobiliary phase imaging, T2 TSE, DWI, and ADC maps. Protocol 3 utilized the standard Gadoxetic Acid-enhanced MRI sequence, which included pre-contrast T1-weighted imaging, T1-weighted Dixon sequences, post-contrast T1-weighted imaging (including arterial, portal venous, transitional and hepatobiliary phases), and additional T2-weighted and DWI sequences. Diagnoses were scored on a 5-point scale (benign = 1; malignant = 5), with scores ≥ 3 indicating CRLM. ROC curves analyzed diagnostic accuracy, comparing area under the curve (AUC) values across protocols. Results No significant difference in AUCs was observed between Protocol 1 (0.899–0.909) and Protocol 2 (0.906–0.931) versus Protocol 3 (0.935–0.939) (p = 0.091–0.195). For lesions ≤ 10 mm, Protocol 1 was slightly inferior to Protocol 3 (p = 0.002–0.032), while Protocol 2 remained comparably effective (p = 0.096–0.179). These findings held when using a threshold of ≥ 4 to define CRLM. Conclusion The non-enhanced abbreviated MRI protocol is as effective as the gadoxetic acid-enhanced protocol in identifying CRLM. The proposed Ab-MRI approach may be a viable alternative for CRLM surveillance. Critical relevance statement The non-enhanced abbreviated MRI (Ab-MRI) protocol is as effective as the gadoxetic acid-enhanced protocol in identifying colorectal liver metastasis (CRLM). The proposed Ab-MRI approach may be a viable alternative for CRLM surveillance. Key Points Two abbreviated protocols are proposed for colorectal liver metastasis (CRLM) surveillance. The non-enhanced protocol showed equivalent efficacy and was more cost-effective. The non-enhanced protocol may be a viable alternative for CRLM surveillance. Graphical Abstract |
| format | Article |
| id | doaj-art-adce8a393b8a42688b532c0fa16d31b1 |
| institution | Kabale University |
| issn | 1869-4101 |
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| publishDate | 2025-01-01 |
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| spelling | doaj-art-adce8a393b8a42688b532c0fa16d31b12025-01-05T12:32:35ZengSpringerOpenInsights into Imaging1869-41012025-01-0116111210.1186/s13244-024-01886-3Comparative evaluation of non-contrast MRI versus gadoxetic acid-enhanced abbreviated protocols in detecting colorectal liver metastasesHaoran Dai0Cheng Yan1Xi Jia2Yuyao Xiao3Xinyue Liang4Chun Yang5Kai Liu6Mengsu Zeng7School of Health Science and Engineering, University of Shanghai For Science and TechnolgyDepartment of Radiology, Zhongshan Hospital, Fudan UniversityDepartment of Radiology, Zhongshan Hospital, Fudan UniversityDepartment of Radiology, Zhongshan Hospital, Fudan UniversityDepartment of Radiology, Zhongshan Hospital, Fudan UniversityDepartment of Radiology, Zhongshan Hospital, Fudan UniversityDepartment of Radiology, Zhongshan Hospital, Fudan UniversityDepartment of Radiology, Zhongshan Hospital, Fudan UniversityAbstract Purpose This study compares the diagnostic efficacy of non-contrast abbreviated MRI protocols with Gadoxetic acid-enhanced abbreviated MRI for detecting colorectal liver metastasis (CRLM), focusing on lesion characterization and surveillance. Methods Ninety-four patients, including 55 with pathologically verified CRLM, were enrolled, totaling 422 lesions (287 metastatic, 135 benign). Two independent readers assessed three MRI protocols per patient: Protocol 1 included non-contrast sequences (T2-weighted turbo spin-echo, T1-weighted Dixon, diffusion-weighted imaging (DWI), and ADC mapping). Protocol 2 included gadoxetic acid enhancement with hepatobiliary phase imaging, T2 TSE, DWI, and ADC maps. Protocol 3 utilized the standard Gadoxetic Acid-enhanced MRI sequence, which included pre-contrast T1-weighted imaging, T1-weighted Dixon sequences, post-contrast T1-weighted imaging (including arterial, portal venous, transitional and hepatobiliary phases), and additional T2-weighted and DWI sequences. Diagnoses were scored on a 5-point scale (benign = 1; malignant = 5), with scores ≥ 3 indicating CRLM. ROC curves analyzed diagnostic accuracy, comparing area under the curve (AUC) values across protocols. Results No significant difference in AUCs was observed between Protocol 1 (0.899–0.909) and Protocol 2 (0.906–0.931) versus Protocol 3 (0.935–0.939) (p = 0.091–0.195). For lesions ≤ 10 mm, Protocol 1 was slightly inferior to Protocol 3 (p = 0.002–0.032), while Protocol 2 remained comparably effective (p = 0.096–0.179). These findings held when using a threshold of ≥ 4 to define CRLM. Conclusion The non-enhanced abbreviated MRI protocol is as effective as the gadoxetic acid-enhanced protocol in identifying CRLM. The proposed Ab-MRI approach may be a viable alternative for CRLM surveillance. Critical relevance statement The non-enhanced abbreviated MRI (Ab-MRI) protocol is as effective as the gadoxetic acid-enhanced protocol in identifying colorectal liver metastasis (CRLM). The proposed Ab-MRI approach may be a viable alternative for CRLM surveillance. Key Points Two abbreviated protocols are proposed for colorectal liver metastasis (CRLM) surveillance. The non-enhanced protocol showed equivalent efficacy and was more cost-effective. The non-enhanced protocol may be a viable alternative for CRLM surveillance. Graphical Abstracthttps://doi.org/10.1186/s13244-024-01886-3Non-contrast MRIGadoxetic acid-enhanced MRIColorectal liver metastasesAbbreviated protocolsDiagnostic efficacy |
| spellingShingle | Haoran Dai Cheng Yan Xi Jia Yuyao Xiao Xinyue Liang Chun Yang Kai Liu Mengsu Zeng Comparative evaluation of non-contrast MRI versus gadoxetic acid-enhanced abbreviated protocols in detecting colorectal liver metastases Insights into Imaging Non-contrast MRI Gadoxetic acid-enhanced MRI Colorectal liver metastases Abbreviated protocols Diagnostic efficacy |
| title | Comparative evaluation of non-contrast MRI versus gadoxetic acid-enhanced abbreviated protocols in detecting colorectal liver metastases |
| title_full | Comparative evaluation of non-contrast MRI versus gadoxetic acid-enhanced abbreviated protocols in detecting colorectal liver metastases |
| title_fullStr | Comparative evaluation of non-contrast MRI versus gadoxetic acid-enhanced abbreviated protocols in detecting colorectal liver metastases |
| title_full_unstemmed | Comparative evaluation of non-contrast MRI versus gadoxetic acid-enhanced abbreviated protocols in detecting colorectal liver metastases |
| title_short | Comparative evaluation of non-contrast MRI versus gadoxetic acid-enhanced abbreviated protocols in detecting colorectal liver metastases |
| title_sort | comparative evaluation of non contrast mri versus gadoxetic acid enhanced abbreviated protocols in detecting colorectal liver metastases |
| topic | Non-contrast MRI Gadoxetic acid-enhanced MRI Colorectal liver metastases Abbreviated protocols Diagnostic efficacy |
| url | https://doi.org/10.1186/s13244-024-01886-3 |
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