Radiology Division, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy.
Gastrointestinal Oncology Division, "Istituto Nazionale Tumori IRCCS Fondazione Pascale - IRCCS di Napoli", Naples, Italy.
PLoS One. 2020 Nov 19;15(11):e0241431. doi: 10.1371/journal.pone.0241431. eCollection 2020.
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.
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 к values were used to evaluate inter-reader agreement of the confidence scale regarding the presence of the lesion.
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).
Abbreviated protocol showed the same detection rate than conventional study in detection of liver metastases.
磁共振成像（MRI）是评估肝转移灶最可靠的影像学手段。本研究旨在比较钆塞酸（Gd-EOB）增强肝脏 MRI 与快速 MRI 方案（包括弥散加权成像（DWI）和 T2 脂肪抑制序列）在术前评估肝转移瘤中的病变检出率和患者检出率。
本研究共纳入 108 例经病理证实的肝转移患者（756 个肝转移灶）。3 名放射科医生分别在 2 周以上的间隔时间内，在仅进行简化方案（DWI 和应用优化对比采样的各向同性翻转角传播（SPACE）脂肪抑制序列）和常规研究（所有采集序列）时，对 5 分置信度量表评估的肝病变存在情况进行独立分级。计算转移瘤的病变检出率和患者检出率。采用加权 к 值评估病变存在的置信度量表的读者间一致性。
MRI 共检出 732 个肝转移灶。所有病变在常规研究和简化方案中均被检出。在肝转移瘤的病变检出率方面，3 名读者在简化方案和 Gd-EOB 标准方案中的检出率均较高（读者 1 为 96.8%[732/756]，96.5%[730/756]；读者 2 为 95.8%[725/756]，95.2%[720/756]；读者 3 为 96.5%[730/756]，96.5%[730/756]）。3 名放射科医生对病变检出率的读者间一致性均为优秀（k 值范围为 0.86-0.98），Gd-EOB MRI 和快速方案的 k 值范围均为 0.89-0.99。
简化方案在检测肝转移瘤方面与常规研究具有相同的检出率。
