Colorectal liver metastases on gadoxetic acid-enhanced MRI: Typical characteristics decrease after chemotherapy

IF 1.5 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Clinical Imaging Pub Date : 2025-03-01 Epub Date: 2025-01-27 DOI:10.1016/j.clinimag.2025.110417

Denise J. van der Reijd , Ezgi A. Soykan , Birthe C. Heeres , Doenja M.J. Lambregts , Marieke A. Vollebergh , Koert F.D. Kuhlmann , Niels F.M. Kok , Petur Snaebjornsson , Regina G.H. Beets-Tan , Monique Maas , Elisabeth G. Klompenhouwer

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Abstract

Purpose

To determine to what extent colorectal liver metastases (CRLM) display typical imaging characteristics on gadoxetic acid-enhanced magnetic resonance imaging (MRI) and what changes after chemotherapy.

Methods

We retrospectively identified 258 patients with a gadoxetic acid-enhanced MRI between 2015 and 2021 and pathologically proven non-mucinous adenocarcinoma CRLM. 722 unique CRLMs were analyzed: 378 CRLM in only the chemotherapy-naïve analysis; 217 in post-chemotherapy analysis; and 127 CRLM were analyzed both pre- and post-chemotherapy. The following six characteristics were defined as typical; “hypovascular”, “unenhanced T1-weighted (UE-T1W) hypointensity”, “arterial rim enhancement”, “non-enhancing during hepatobiliary phase”, “T2-weighted (T2W) mild hyperintensity”, and “diffusion restriction”.

Results

All six typical characteristics were found in 249/505 chemotherapy-naïve CRLM (49 %) and 87/344 post-chemotherapy CRLM (25 %). The occurrence of some typical characteristics decreased post-chemotherapy: UE-T1W hypointensity 485/505 (96 %) versus 311/336 (93 %), arterial rim enhancement 291/498 (58 %) versus 154/301 (51 %), T2W mild hyperintensity 478/505 (95 %) versus 269/338 (79 %), and diffusion restriction 435/497 (87 %) versus 200/306 (65 %). Almost all metastases showed a hypovascular appearance, both in the chemotherapy-naïve (495/504, 98 %) and post-chemotherapy group (330/331, 100 %). Additionally, all CRLM appeared non-enhancing compared to the liver in the hepatobiliary phase (100 %).

Conclusion

Most CRLM show various combinations of at least five typical characteristics on gadoxetic acid-enhanced MRI. Arterial rim enhancement is the least prevalent characteristic both in chemotherapy-naïve and post-chemotherapy patients. Post-chemotherapy the occurrence of typical MRI characteristics decreases, especially mild T2W hyperintensity and the presence of diffusion restriction.

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加多西酸增强MRI显示结直肠肝转移：化疗后典型特征减少。

目的：探讨结直肠肝转移瘤（CRLM）在磁共振成像（MRI）上表现出的典型影像学特征及化疗后的变化。方法：我们回顾性地确定了2015年至2021年期间258例经病理证实的非粘液性腺癌CRLM的gadoxetic酸增强MRI患者。分析了722个独特的CRLM：仅chemotherapy-naïve分析的CRLM为378个；化疗后分析217例；并对化疗前后127例CRLM进行分析。以下六个特征被定义为典型：“低血管”、“未增强的t1加权（UE-T1W）低信号”、“动脉边缘增强”、“肝胆期未增强”、“t2加权（T2W）轻度高信号”和“扩散受限”。结果：249/505 chemotherapy-naïve化疗后CRLM（49%）和87/344化疗后CRLM（25%）均有6个典型特征。化疗后一些典型特征的发生率降低：UE-T1W低信号485/505（96%）比311/336(93%)，动脉边缘强化291/498（58%）比154/301 (51%)，T2W轻度高信号478/505（95%）比269/338(79%)，扩散受限435/497（87%）比200/306（65%）。在chemotherapy-naïve组（495/ 504,98 %）和化疗后组（330/ 331,100 %）中，几乎所有转移灶都表现为低血管外观。此外，与肝胆期的肝脏相比，所有的CRLM都没有增强（100%）。结论：大多数CRLM在加多辛酸增强MRI上表现出至少五种典型特征的不同组合。动脉边缘增强是chemotherapy-naïve和化疗后患者中最不普遍的特征。化疗后典型MRI特征的出现减少，尤其是轻度T2W高信号和弥散受限。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Imaging 医学-核医学

CiteScore

4.60

自引率

0.00%

发文量

265

审稿时长

35 days

期刊介绍： The mission of Clinical Imaging is to publish, in a timely manner, the very best radiology research from the United States and around the world with special attention to the impact of medical imaging on patient care. The journal''s publications cover all imaging modalities, radiology issues related to patients, policy and practice improvements, and clinically-oriented imaging physics and informatics. The journal is a valuable resource for practicing radiologists, radiologists-in-training and other clinicians with an interest in imaging. Papers are carefully peer-reviewed and selected by our experienced subject editors who are leading experts spanning the range of imaging sub-specialties, which include: -Body Imaging- Breast Imaging- Cardiothoracic Imaging- Imaging Physics and Informatics- Molecular Imaging and Nuclear Medicine- Musculoskeletal and Emergency Imaging- Neuroradiology- Practice, Policy & Education- Pediatric Imaging- Vascular and Interventional Radiology