Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Radiology, Yonsei Biomedical Research Institute, Research Institute of Radiological Science, Seoul, Korea.
PLoS One. 2024 Nov 4;19(11):e0313212. doi: 10.1371/journal.pone.0313212. eCollection 2024.
We aimed to assess imaging findings and detection sensitivity for melanoma liver metastases on gadoxetic acid-enhanced magnetic resonance imaging (MRI).
This retrospective study included patients with melanoma liver metastasis who underwent gadoxetic acid-enhanced MRI. Two abdominal radiologists independently evaluated signal characteristics of liver metastases on morphologic imaging (precontrast T1- and T2-weighted imaging), diffusion-weighted imaging (DWI), dynamic imaging, and hepatobiliary phase (HBP). Imaging findings were compared according to detection on HBP and the primary site of the melanoma using logistic regression with the generalized estimating equation (GEE). Detection sensitivity for metastases was compared among different MR imaging sets using logistic regression with GEE.
A total of 67 patients with 254 liver metastases were included (44 women; mean age ± standard deviation, 65.6 ± 13.0 years). On HBP, 76.0% of metastases were detected, and 55.5% (141/254) showed hypointensity. Most of the metastases that were not detected on HBP originated from ocular melanomas (98.4%, 60/61), ≤1 cm (90.2%, 55/61) and showed T1 hyperintensity (98.4%, 60/61). Metastases from non-ocular melanomas more frequently showed T1 hypointensity, T2 hyperintensity, diffusion restriction, arterial enhancement, and HBP hypointensity than those from ocular melanomas (Ps ≤ 0.019). The detection sensitivity of HBP (76.0%) was significantly higher than DWI (65.7%, P = 0.006), but lower than morphologic imaging (98.8%, P < 0.001) and dynamic imaging (97.6%, P < 0.001).
The detection sensitivity of HBP for melanoma liver metastasis was 76.0%, which was lower than that of morphologic or dynamic imaging. HBP of gadoxetic acid-enhanced MRI has little advantage in detecting melanoma liver metastases.
本研究旨在评估钆塞酸增强磁共振成像（MRI）对黑素瘤肝转移的影像学表现和检测灵敏度。
本回顾性研究纳入了经钆塞酸增强 MRI 检查的黑素瘤肝转移患者。2 名腹部放射科医生独立评估了形态学成像（平扫 T1 加权成像和 T2 加权成像）、扩散加权成像（DWI）、动态成像和肝胆期（HBP）的肝转移信号特征。采用广义估计方程（GEE）的逻辑回归比较了 HBP 与黑素瘤原发部位检测结果的影像学表现，并采用 GEE 的逻辑回归比较了不同 MRI 成像组合对转移灶的检测灵敏度。
共纳入 67 例患者（44 例女性；平均年龄±标准差，65.6±13.0 岁）的 254 个肝转移灶。在 HBP 上，76.0%的转移灶被检出，55.5%（141/254）表现为低信号。未在 HBP 上检出的转移灶主要来源于眼黑素瘤（98.4%，60/61），直径≤1cm（90.2%，60/61），且 T1 呈高信号（98.4%，60/61）。与眼黑素瘤相比，非眼黑素瘤来源的转移灶更常表现为 T1 低信号、T2 高信号、弥散受限、动脉期强化和 HBP 低信号（P≤0.019）。HBP 的检测灵敏度（76.0%）明显高于 DWI（65.7%，P=0.006），但低于形态学成像（98.8%，P<0.001）和动态成像（97.6%，P<0.001）。
HBP 对黑素瘤肝转移的检测灵敏度为 76.0%，低于形态学或动态成像。在检测黑素瘤肝转移方面，HBP 对钆塞酸增强 MRI 没有明显优势。
