1. Accuracy of gadoxetic acid-enhanced magnetic resonance imaging for the diagnosis of sinusoidal obstruction syndrome in patients with chemotherapy-treated colorectal liver metastases.
- Author
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Shin NY, Kim MJ, Lim JS, Park MS, Chung YE, Choi JY, Kim KW, and Park YN
- Subjects
- Adult, Aged, Antineoplastic Agents therapeutic use, Colorectal Neoplasms pathology, Colorectal Neoplasms therapy, Contrast Media, Female, Hepatic Veno-Occlusive Disease chemically induced, Humans, Image Enhancement methods, Liver Neoplasms surgery, Male, Middle Aged, ROC Curve, Reproducibility of Results, Retrospective Studies, Sensitivity and Specificity, Antineoplastic Agents adverse effects, Colorectal Neoplasms secondary, Gadolinium DTPA, Hepatic Veno-Occlusive Disease diagnosis, Liver Neoplasms drug therapy, Liver Neoplasms secondary, Magnetic Resonance Imaging methods
- Abstract
Objective: To assess whether reticular hypointensity on hepatobiliary phase images of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) is a diagnostic finding of sinusoidal obstruction syndrome (SOS) in patients with hepatic metastases who have undergone chemotherapy., Methods: We retrospectively analysed EOB-MRI of 42 patients who had undergone chemotherapy before hepatic resection of colorectal hepatic metastases. Two radiologists, who were unaware of whether or not the patients had SOS, reviewed the hepatobiliary phase images to determine the presence of hypointense reticulation in the liver using a 5-point scale. The sensitivity, specificity and area under the receiver operating characteristics curve (A(z)) were calculated for each reviewer., Results: The sensitivity, specificity and A(z) for the diagnosis of SOS were 75%, 100% and 0.957 for reader 1 and 75%, 96.2% and 0.936 for reader 2, respectively. In one patient who received a false-positive diagnosis by one reader, there was sinusoidal fibrosis on histological examination, but not diagnostic for SOS. False-negative diagnosis occurred in four patients for both readers; histology of these patients showed minimal and localised sinusoidal congestion and fibrosis., Conclusions: Reticular hypointensity on hepatobiliary phase images of EOB-MRI is highly specific for the diagnosis of SOS in patients with treated colorectal hepatic metastases., Key Points: Gadoxetic acid enhanced magnetic resonance imaging (EOB-MRI) can identify the sinusoidal obstruction syndrome (SOS). The diagnosis can be achieved with high specificity and good interobserver agreement. SOS typically demonstrates diffuse hypointensity on hepatobiliary phase images on EOB-MRI. EOB-MRI may be falsely negative in patients with minimal degree of SOS.
- Published
- 2012
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