Clinical performance of a simulated abbreviated liver magnetic resonance imaging in combination with contrast-enhanced computed tomography for the baseline evaluation of the liver in patients with colorectal cancer

• Published in: Clinical radiology 2024-11, Vol.80, p.106743, Article 106743
• Main Authors: Castagnoli, F., Withey, S.J., Konidari, M., Chau, I., Riddell, A., Shur, J., Messiou, C., Koh, D.M.
• Format: Article
• Language: English
• ISSN: 0009-9260; 1365-229X; 1365-229X
• DOI: 10.1016/j.crad.2024.106743

To assess the diagnostic accuracy and inter-reader agreement of a simulated abbreviated gadoxetate liver magnetic resonance imaging (MRI) protocol together with contrast-enhanced computed tomography (CE-CT) against a standard gadoxetate MRI for the detection of colorectal liver metastases at baseline. Three readers independently evaluated two sets of images per patient, recording number and location of metastases and benign lesions. Set 1 comprised T1w, T2w, DWI, multiphase CE-T1w, and hepatobiliary phase (HBP) images (standard). Set 2 included T2w, HBP, DWI (from Set 1) and CE-CT (simulated abbreviated). Diagnostic performance was compared using McNemar’s test. The level of agreement between sets 1 and 2 was determined with Cohen kappa. For agreement in the number of benign lesions and metastases, we applied intraclass correlation coefficient (ICC). Seventy-five patients (245 metastases, 122 benign lesions) were evaluated. There was no significant difference in diagnostic accuracy between set 1 and 2 for each reader (mean P = 0.74). The total number of metastases and benign lesions showed high agreement between reading set 1 and 2 (κ = 0.81, 0.78). The total number of metastases showed substantial agreement between readers for set 1 and 2 (ICC = 0.99, 0.99). Good agreement was seen for metastatic segmental involvement (κ = 0.84–0.99). At baseline, using a simulated abbreviated liver MRI together with CE-CT showed excellent agreement with standard MRI protocol for liver metastasis detection. •The baseline use of abbreviated liver MRI + CE-CT does not compromise diagnostic accuracy.•High agreement in metastasis and benign lesion counts for standard vs abbreviated set.•Abbreviated gadoxetate liver MRI protocol has an estimated scan time of 10–15 minutes.