Attiyeh Marc A, Malhotra Gautam K, Li Daneng, Manoukian Saro B, Motarjem Pejman M, Singh Gagandeep
Department of Surgical Oncology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Department of Surgery, USC, Keck School of Medicine, Los Angeles, CA 90033, USA.
Cancers (Basel). 2023 Oct 23;15(20):5109. doi: 10.3390/cancers15205109.
We compared CT and MRI for staging metastatic colorectal or neuroendocrine liver metastases (CRLMs and NELMs, respectively) to assess their impact on tumor burden.
A prospectively maintained database was queried for patients who underwent both imaging modalities within 3 months, with two blinded radiologists (R1 and R2) independently assessing the images for liver lesions. To minimize recall bias, studies were grouped by modality, and were randomized and evaluated separately.
Our query yielded 76 patients (42 CRLMs; 34 NELMs) with low interrater variability (intraclass correlation coefficients: CT = 0.941, MRI = 0.975). For CRLMs, there were no significant differences in lesion number or size between CT and MRI. However, in NELMs, Eovist-enhanced MRI detected more lesions (R1: 14.3 vs. 12.1, = 0.02; R2: 14.4 vs. 12.4, = 0.01) and smaller lesions (R1: 5.7 vs. 4.4, = 0.03; R2: 4.8 vs. 2.9, = 0.02) than CT.
CT and MRI are equivalent for CRLMs, but for NELMs, MRI outperforms CT in detecting more and smaller lesions, potentially influencing treatment planning and surgery.
我们比较了CT和MRI对转移性结直肠癌或神经内分泌肝转移瘤（分别为CRLMs和NELMs）进行分期，以评估它们对肿瘤负荷的影响。
查询一个前瞻性维护的数据库，找出在3个月内接受了两种成像检查的患者，由两名盲法放射科医生（R1和R2）独立评估肝脏病变的图像。为尽量减少回忆偏倚，研究按检查方式分组，随机并分别进行评估。
我们的查询得到了76例患者（42例CRLMs；34例NELMs），评分者间变异性较低（组内相关系数：CT = 0.941，MRI = 0.975）。对于CRLMs，CT和MRI在病变数量或大小上没有显著差异。然而，在NELMs中，与CT相比，Eovist增强MRI检测到更多的病变（R1：14.3对12.1，P = 0.02；R2：14.4对12.4，P = 0.01）和更小的病变（R1：5.7对4.4，P = 0.03；R2：4.8对2.9，P = 0.02）。
对于CRLMs，CT和MRI等效，但对于NELMs，MRI在检测更多和更小的病变方面优于CT，这可能会影响治疗计划和手术。
