Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis
Background:. Abdominal computed tomography (CT) is the standard imaging modality for detection and staging in patients with colorectal liver metastases (CRLM). Although liver magnetic resonance imaging (MRI) is superior to CT in detecting small lesions, guidelines are ambiguous regarding the added v...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-03-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000401 |
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| author | Burak Görgec, MD Inez M. Verpalen, MD, PhD Jasper P. Sijberden, MD Mohammad Abu Hilal, MD, PhD Shandra Bipat, PhD Cornelis Verhoef, MD, PhD Rutger-Jan Swijnenburg, MD, PhD Marc G. Besselink, MD, MSc, PhD Jaap Stoker, MD, PhD |
| author_facet | Burak Görgec, MD Inez M. Verpalen, MD, PhD Jasper P. Sijberden, MD Mohammad Abu Hilal, MD, PhD Shandra Bipat, PhD Cornelis Verhoef, MD, PhD Rutger-Jan Swijnenburg, MD, PhD Marc G. Besselink, MD, MSc, PhD Jaap Stoker, MD, PhD |
| author_sort | Burak Görgec, MD |
| collection | DOAJ |
| description | Background:. Abdominal computed tomography (CT) is the standard imaging modality for detection and staging in patients with colorectal liver metastases (CRLM). Although liver magnetic resonance imaging (MRI) is superior to CT in detecting small lesions, guidelines are ambiguous regarding the added value of an additional liver MRI in the surgical workup of patients with CRLM. Therefore, this systematic review and meta-analysis aimed to evaluate the clinical added value of liver MRI in patients eligible for resection or ablation of CRLM based on CT.
Methods:. A systematic search was performed in the PubMed, Embase, and Cochrane Library databases through June 23, 2023. Studies investigating the impact of additional MRI on local treatment plan following CT in patients with CRLM were included. Risk of bias was assessed using the QUADAS-2 tool. The pooled weighted proportions for the primary outcome were calculated using random effect meta-analysis.
Results:. Overall, 11 studies with 1440 patients were included, of whom 468 patients (32.5%) were assessed for change in local treatment plan. Contrast-enhanced liver MRI was used in 10 studies, including gadoxetic acid in 9 studies. Liver MRI with diffusion-weighted imaging was used in 8 studies. Pooling of data found a 24.12% (95% confidence interval, 15.58%–32.65%) change in the local treatment plan based on the added findings of liver MRI following CT. Sensitivity analysis including 5 studies (268 patients) focusing on monophasic portal venous CT followed by gadoxetic acid-enhanced liver MRI with diffusion-weighted imaging showed a change of local treatment plan of 17.88% (95% confidence interval, 5.14%–30.62%).
Conclusions:. This systematic review and meta-analysis found that liver MRI changed the preinterventional local treatment plan in approximately one-fifth of patients eligible for surgical resection or ablation of CRLM based on CT. These findings suggest a clinically relevant added value of routine liver MRI in the preinterventional workup of CRLM, which should be confirmed by large prospective studies. |
| format | Article |
| id | doaj-art-4249ba1e79f94e00a87b47f9787bb57a |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-4249ba1e79f94e00a87b47f9787bb57a2025-01-24T09:18:25ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-03-0151e40110.1097/AS9.0000000000000401202403000-00036Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-AnalysisBurak Görgec, MD0Inez M. Verpalen, MD, PhD1Jasper P. Sijberden, MD2Mohammad Abu Hilal, MD, PhD3Shandra Bipat, PhD4Cornelis Verhoef, MD, PhD5Rutger-Jan Swijnenburg, MD, PhD6Marc G. Besselink, MD, MSc, PhD7Jaap Stoker, MD, PhD8* From the Department of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands† Cancer Center Amsterdam, Amsterdam, The Netherlands* From the Department of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands§ Department of Surgery, Poliambulanza Foundation Hospital, Brescia, Italy‡ Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands‖ Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus Medical Center, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.* From the Department of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands* From the Department of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands† Cancer Center Amsterdam, Amsterdam, The NetherlandsBackground:. Abdominal computed tomography (CT) is the standard imaging modality for detection and staging in patients with colorectal liver metastases (CRLM). Although liver magnetic resonance imaging (MRI) is superior to CT in detecting small lesions, guidelines are ambiguous regarding the added value of an additional liver MRI in the surgical workup of patients with CRLM. Therefore, this systematic review and meta-analysis aimed to evaluate the clinical added value of liver MRI in patients eligible for resection or ablation of CRLM based on CT. Methods:. A systematic search was performed in the PubMed, Embase, and Cochrane Library databases through June 23, 2023. Studies investigating the impact of additional MRI on local treatment plan following CT in patients with CRLM were included. Risk of bias was assessed using the QUADAS-2 tool. The pooled weighted proportions for the primary outcome were calculated using random effect meta-analysis. Results:. Overall, 11 studies with 1440 patients were included, of whom 468 patients (32.5%) were assessed for change in local treatment plan. Contrast-enhanced liver MRI was used in 10 studies, including gadoxetic acid in 9 studies. Liver MRI with diffusion-weighted imaging was used in 8 studies. Pooling of data found a 24.12% (95% confidence interval, 15.58%–32.65%) change in the local treatment plan based on the added findings of liver MRI following CT. Sensitivity analysis including 5 studies (268 patients) focusing on monophasic portal venous CT followed by gadoxetic acid-enhanced liver MRI with diffusion-weighted imaging showed a change of local treatment plan of 17.88% (95% confidence interval, 5.14%–30.62%). Conclusions:. This systematic review and meta-analysis found that liver MRI changed the preinterventional local treatment plan in approximately one-fifth of patients eligible for surgical resection or ablation of CRLM based on CT. These findings suggest a clinically relevant added value of routine liver MRI in the preinterventional workup of CRLM, which should be confirmed by large prospective studies.http://journals.lww.com/10.1097/AS9.0000000000000401 |
| spellingShingle | Burak Görgec, MD Inez M. Verpalen, MD, PhD Jasper P. Sijberden, MD Mohammad Abu Hilal, MD, PhD Shandra Bipat, PhD Cornelis Verhoef, MD, PhD Rutger-Jan Swijnenburg, MD, PhD Marc G. Besselink, MD, MSc, PhD Jaap Stoker, MD, PhD Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis Annals of Surgery Open |
| title | Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis |
| title_full | Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis |
| title_fullStr | Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis |
| title_short | Added Value of Liver MRI in Patients Eligible for Surgical Resection or Ablation of Colorectal Liver Metastases Based on CT: A Systematic Review and Meta-Analysis |
| title_sort | added value of liver mri in patients eligible for surgical resection or ablation of colorectal liver metastases based on ct a systematic review and meta analysis |
| url | http://journals.lww.com/10.1097/AS9.0000000000000401 |
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