Noguchi Yuka, Einama Takahiro, Ohara Mayuko, Ichio Koki, Kobayashi Kazuki, Yonamine Naoto, Tsunenari Takazumi, Takihata Yasuhiro, Takao Mikiya, Edo Hiromi, Okamoto Koichi, Kajiwara Yoshiki, Shinto Eiji, Ogata Sho, Ueno Hideki, Shinmoto Hiroshi, Kishi Yoji
Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
Sci Rep. 2025 Jul 2;15(1):22632. doi: 10.1038/s41598-025-08243-4.
Recent advances in chemotherapy have expanded the opportunity for curative resection of colorectal liver metastases (CRLMs). Disappearing liver metastases (DLMs) are often encountered following chemotherapy. This study aimed to determine whether the DLMs observed by contrast-enhanced computed tomography (CECT) and gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) following preoperative chemotherapy were associated with a pathologic complete response(pCR). Patients who underwent hepatectomy between April 2020 and December 2022, following preoperative chemotherapy at our institution, were selected. Before chemotherapy, all patients underwent CECT, some patients also underwent EOB-MRI, and both imaging studies were performed on all patients after chemotherapy. Pathologic responses of all resected tumors were evaluated. For the unresected DLMs, they were defined as DLMs if they did not reappear in the imaging studies conducted over the following year. A total of 29 patients were selected. After chemotherapy, 138 DLMs were found by CECT and 106 were found by EOB-MRI. Of the resected DLMs confirmed only by CECT, tumor cells remained in 90% of them. All of resected DLMs confirmed by EOB-MRI showed a pCR. Of the remaining 39 unresected DLMs, one reappeared within a year. EOB-MRI is superior to CECT for the diagnosis of DLMs.
化疗方面的最新进展扩大了结直肠癌肝转移（CRLMs）根治性切除的机会。化疗后常出现肝转移灶消失（DLMs）的情况。本研究旨在确定术前化疗后通过对比增强计算机断层扫描（CECT）和钆塞酸二钠增强磁共振成像（EOB-MRI）观察到的DLMs是否与病理完全缓解（pCR）相关。选取了2020年4月至2022年12月在本机构接受术前化疗后行肝切除术的患者。化疗前，所有患者均接受CECT检查，部分患者还接受了EOB-MRI检查，化疗后所有患者均进行了这两种影像学检查。评估所有切除肿瘤的病理反应。对于未切除的DLMs，如果在接下来一年进行的影像学检查中未再次出现，则将其定义为DLMs。共选取了29例患者。化疗后，CECT发现138个DLMs，EOB-MRI发现106个DLMs。在仅通过CECT确诊的切除DLMs中，90%仍有肿瘤细胞残留。所有通过EOB-MRI确诊的切除DLMs均显示为pCR。在其余39个未切除的DLMs中，有1个在一年内再次出现。在DLMs的诊断方面，EOB-MRI优于CECT。
