Utility of combined gadoxetic acid and ferumoxytol-enhanced liver MRI for preoperative detection of colorectal cancer liver metastases: a pilot study

Carney, Benjamin W, Gholami, Sepideh, Fananapazir, Ghaneh, Sekhon, Simran, Lamba, Ramit, Loehfelm, Thomas W, Wilson, Machelle D, Corwin, Michael T (November 2022) Utility of combined gadoxetic acid and ferumoxytol-enhanced liver MRI for preoperative detection of colorectal cancer liver metastases: a pilot study. Acta Radiologica, 64 (4). pp. 1357-1362. ISSN 0284-1851

Abstract

BACKGROUND: Colorectal cancer (CRC) is the second-leading cause of cancer-related death worldwide and resection of CRC metastases confined to the liver is the treatment of choice when feasible. Ferumoxytol is an off-label contrast agent that opacifies vasculature and may be helpful in distinguishing metastases from small hemangiomas and blood vessels on gadoxetic acid-enhanced magnetic resonance imaging (MRI). PURPOSE: To compare the diagnostic accuracy of MRI using a standard gadoxetic acid protocol and a combined gadoxetic acid/ferumoxytol protocol in patients with suspected colorectal hepatic metastases. MATERIAL AND METHODS: In this institutional review board-approved, single-institution, retrospective study, eight patients underwent gadoxetic acid-enhanced liver MRI, supplemented with additional T1-weighted ferumoxytol enhanced sequences. Two radiologists in consensus identified all metastases using all available sequences, which served as the reference standard. Two different radiologists reviewed each exam twice, once using the standard protocol and once with additional ferumoxytol sequences. The detection rate was estimated as the predicted probability of a metastasis along with the 95% confidence interval (CI) using hierarchical logistic regression models. RESULTS: A total of 49 metastases were identified. The mean diameter was 10 mm, measured in greatest axial dimension (median=7 mm; range=2-70 mm). Readers 1 and 2 had detection rates of 69.6% (95% CI = 48.2-85.0) and 53.1% (95% CI = 35.2-70.3) for gadoxetic acid alone and 98.0% (95% CI = 86.3-99.7) and 83.5% (95% CI = 59.3-94.7) for combined protocol. CONCLUSION: In this preliminary investigation, adding ferumoxytol-enhanced sequences to gadoxetic acid liver MRI protocol increased the detection rate of CRC hepatic metastases and may aid in preoperative decision making.

Item Type: Paper
Subjects: diseases & disorders > cancer
diseases & disorders
Investigative techniques and equipment
diseases & disorders > neoplasms
diseases & disorders > cancer > cancer types > colon cancer
diseases & disorders > cancer > cancer types > colon cancer
Investigative techniques and equipment > imaging
diseases & disorders > cancer > cancer types > liver cancer
Investigative techniques and equipment > magnetic resonance imaging
diseases & disorders > cancer > cancer types
CSHL Authors:
Communities: CSHL labs > Gholami Lab
SWORD Depositor: CSHL Elements
Depositing User: CSHL Elements
Date: November 2022
Date Deposited: 27 Sep 2023 19:21
Last Modified: 11 Jan 2024 19:07
Related URLs:
URI: https://repository.cshl.edu/id/eprint/41007

Actions (login required)

Administrator's edit/view item Administrator's edit/view item