ArticleThe British journal of radiology2025
Enhancement of colorectal cancer liver metastases with gadoxetate-enhanced MRI at multiple time points is associated with disease-free survival following hepatectomy.
Article in The British journal of radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo investigate signal intensity of colorectal cancer liver metastases (CRLM) at hepatobiliary phase (HBP) gadoxetate-enhanced MRI at 2 time points pre- (TP1) and post- chemotherapy (TP2) and association with disease-free survival (DFS) in patients undergoing curative liver resection.
methodsRetrospective study was conducted. Single largest tumours were outlined and HBP T1 signal intensity was measured and normalized to skeletal muscle at TP1 and TP2. Enhancement thresholds were defined and risk groups at each TP and Kaplan-Meier survival curves were compared using the log-rank test. Univariate and multivariate association of enhancement and 8 clinical features with risk of recurrence were calculated using Cox proportional hazards.
results82 patients (48 male, mean age 59 years) underwent 135 imaging studies, 58 at TP1, 77 at TP2, and 53 patients at TP1 + 2. Of 82 patients, 58 recurred with a median time to recurrence of 11.7 months. Enhancement of ≥135 and ≥15 at TP1 and TP2, respectively, were predictive of reduced risk of recurrence (P < .05), although not when corrected for multiple testing (P = .33 and .20, respectively). Enhancement was not associated with recurrence in multivariate model including 8 clinical features (P > .05). Change in enhancement between TP was not associated with risk of recurrence; however, tumours that consistently exhibited low enhancement were 9 times more likely to recur.
conclusionsIncreased CRLM enhancement in the HBP following gadoxetic acid at 2 TPs is associated with improved DFS in patients undergoing liver resection. This initial observation warrants further investigation of serial enhancement measurements as prognostic biomarkers. ADVANCES IN KNOWLEDGE: Dual-time point signal assessment may be informative for clinical outcomes in CRLM undergoing resection.
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