Hepatic steatosis assessment with CT or MRI in patients with colorectal liver metastases after neoadjuvant chemotherapy

Purpose Preoperative radiological assessment of hepatic steatosis is recommended in patients undergoing a liver resection, but few studies investigated the diagnostic accuracy after neoadjuvant chemotherapy. The aim of this study was to compare diagnostic accuracy of preoperative CT or MRI measureme...

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Published in:	Journal of surgical oncology Vol. 104; no. 1; pp. 10 - 16
Main Authors:	Marsman, H.A., van der Pool, A.E., Verheij, J., Padmos, J., ten Kate, F.J.W., Dwarkasing, R.S., van Gulik, T.M., Ijzermans, J.N.M., Verhoef, C.
Format:	Journal Article
Language:	English
Published:	Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-07-2011
Subjects:	Antineoplastic Combined Chemotherapy Protocols - adverse effects Cohort Studies Colorectal Neoplasms - drug therapy Colorectal Neoplasms - pathology Fatty Liver - chemically induced Fatty Liver - diagnosis Female hepatic steatosis Humans Liver Neoplasms - drug therapy Liver Neoplasms - secondary Magnetic Resonance Imaging Male Middle Aged neoadjuvant chemotherapy Neoadjuvant Therapy Neoplasm Recurrence, Local - drug therapy Neoplasm Recurrence, Local - pathology non-invasive detection Prospective Studies Sensitivity and Specificity Survival Rate Tomography, X-Ray Computed Treatment Outcome
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Summary:	Purpose Preoperative radiological assessment of hepatic steatosis is recommended in patients undergoing a liver resection, but few studies investigated the diagnostic accuracy after neoadjuvant chemotherapy. The aim of this study was to compare diagnostic accuracy of preoperative CT or MRI measurements of steatosis in patients with colorectal liver metastases after induction chemotherapy. Methods MRI measurements (relative signal intensity decrease; RSID), N = 36, and CT scan measurements (Hounsfield units; HU), N = 32, were compared with histological steatosis assessment. Diagnostic accuracy was determined for detecting any (>5%) or marked macrovesicular steatosis (>33%). Results MRI showed the highest correlation with histology (r = 0.82, P < 0.001), compared to CT measurements (r = −0.65, P < 0.001). Based on linear regression analysis, radiological cut‐off values for 5% and 33% macrovesicular steatosis, corresponded to 0.7% and 19.2% RSID in the MRI‐group, and 60.4 and 54.2 HU in the CT‐group, respectively. Sensitivity and specificity for the detection of any and marked macrovesicular steatosis using MRI was 87% and 69%, and 78% and 100%, respectively, and for CT, 83% and 64%, and 70% and 87%, respectively. Conclusion In patients treated with neoadjuvant chemotherapy MRI measurements of steatosis showed the highest correlation coefficient and the best diagnostic accuracy, as compared to CT measurements. J. Surg. Oncol. 2011;104:10–16. © 2011 Wiley‐Liss, Inc.
Bibliography:	ArticleID:JSO21874 ark:/67375/WNG-55QZD0ND-Z istex:EFDFF52EB2F52385C1E71C18A31048AEA7B15AE8 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0022-4790 1096-9098
DOI:	10.1002/jso.21874