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Purpose <p>To intra-individually compare the diagnostic performance of hepatobiliary phase (HBP)-abbreviated MRI (AMRI) and contrast-enhanced CT (CE-CT) in postoperative surveillance of colorectal liver metastases (CRLMs).</p> Methods <p>This multicenter prospective study enrolled 462 patients with colorectal cancer who underwent paired CE-CT and HBP-AMRI every six months over a 24-month surveillance period. The HBP-AMRI protocol comprised T2-weighted imaging, diffusion-weighted imaging, and HBP at 10&#xa0;min post-injection, with total acquisition optimized to 5&#xa0;min. Lesion detection rates for all and subcentimeter lesions, and patient-level sensitivity, specificity, and accuracy were compared between CE-CT and HBP-AMRI by McNemar χ<sup>2</sup> test. Receiver operating characteristic (ROC) curves were constructed across all surveillance intervals.</p> Results <p>HBP-AMRI demonstrated ​significantly higher detection rates​ than CE-CT across all surveillance rounds for all and subcentimeter lesions (all <i>P</i> &lt; 0.05). The pooled 24-month data demonstrated HBP-AMRI significantly outperformed CE-CT in specificity (overall: 94.35% vs. 86.92%; <i>P</i> &lt; 0.001), and accuracy (overall: 94.04% vs. 86.23%; <i>P</i> &lt; 0.001). A consistent trend was observed across each individual surveillance round. The pooled 24-month analysis revealed HBP-AMRI had significantly higher sensitivity than CE-CT (overall: 90.35% vs. 78.07%; <i>P</i> = 0.023). HBP-AMRI maintained a superior negative predictive value (NPV) compared with CE-CT (overall: 99.14% vs. 97.91%), and higher positive predictive value (PPV) compared with CE-CT (overall: 57.54% vs. 33.59%) across all surveillance rounds.</p> Conclusion <p>HBP-AMRI with a 5-minute streamlined workflow substantially outperforms CE-CT in lesion detection rate and patient-level diagnostic performance of CRLMs. HBP-AMRI can provide an efficient and safe alternative modality with longitudinal reliability for postoperative surveillance of CRLM in colorectal cancer patients.</p>

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Intra-individual comparison of abbreviated gadoxetic acid–enhanced MRI and contrast-enhanced CT for postoperative surveillance of colorectal liver metastases: a multicenter prospective study

  • 期刊论文

  • 发表日期：

    2025年11月4日

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  • Qian Xu,
  • Fukun Shi,
  • Lifeng Wang,
  • Xianzheng Tan,
  • Junjie Shu,
  • Jiameng Si,
  • Yihao Yan,
  • Yu Gao,
  • Xiaoyang Zhai,
  • Zhichao Feng,
  • Lan Zhang

摘要

Purpose

To intra-individually compare the diagnostic performance of hepatobiliary phase (HBP)-abbreviated MRI (AMRI) and contrast-enhanced CT (CE-CT) in postoperative surveillance of colorectal liver metastases (CRLMs).

Methods

This multicenter prospective study enrolled 462 patients with colorectal cancer who underwent paired CE-CT and HBP-AMRI every six months over a 24-month surveillance period. The HBP-AMRI protocol comprised T2-weighted imaging, diffusion-weighted imaging, and HBP at 10 min post-injection, with total acquisition optimized to 5 min. Lesion detection rates for all and subcentimeter lesions, and patient-level sensitivity, specificity, and accuracy were compared between CE-CT and HBP-AMRI by McNemar χ2 test. Receiver operating characteristic (ROC) curves were constructed across all surveillance intervals.

Results

HBP-AMRI demonstrated ​significantly higher detection rates​ than CE-CT across all surveillance rounds for all and subcentimeter lesions (all P < 0.05). The pooled 24-month data demonstrated HBP-AMRI significantly outperformed CE-CT in specificity (overall: 94.35% vs. 86.92%; P < 0.001), and accuracy (overall: 94.04% vs. 86.23%; P < 0.001). A consistent trend was observed across each individual surveillance round. The pooled 24-month analysis revealed HBP-AMRI had significantly higher sensitivity than CE-CT (overall: 90.35% vs. 78.07%; P = 0.023). HBP-AMRI maintained a superior negative predictive value (NPV) compared with CE-CT (overall: 99.14% vs. 97.91%), and higher positive predictive value (PPV) compared with CE-CT (overall: 57.54% vs. 33.59%) across all surveillance rounds.

Conclusion

HBP-AMRI with a 5-minute streamlined workflow substantially outperforms CE-CT in lesion detection rate and patient-level diagnostic performance of CRLMs. HBP-AMRI can provide an efficient and safe alternative modality with longitudinal reliability for postoperative surveillance of CRLM in colorectal cancer patients.