Detection of liver metastases in colorectal cancer on chemotherapy

Objective. To compare MRI of the liver with mangafodipir trisodium (MnDPDP) and computed tomography with intravenous contrast media in the follow-up of liver metastases in patient on chemotherapy for colorectal carcinoma. Materials and methods. This was a prospective study with patients on chemotherapy for liver metastases from colorectal cancer. Patients underwent both contrast-enhanced helical CT using 2 cc/kg contrast at 3 cc/sec and mangafodipir trisodium-enhanced MR imaging at 1.5 T using 2-3 cc/min contrast at 5 mumol/kg within a two week interval. Two experienced radiologists independently reviewed all scans in a blinded fashion and recorded image quality as well as presence and number of liver lesions. Statistical analysis was performed using the wilcoxon signed rank test. Results. All examinations were of good quality. A total of 71 lesions were detected at CT, with 69 lesions consistent with metastases and 2 lesions consistent with cysts. A total of 98 lesions were detected at MRI, with 97 consistent with metastases and I lesion consistent with a cyst. T1 weighted images with MnDPDP significantly detected two additional lesions compared to CT (p < 0,05). No significant difference was demonstrated between T1 weighted images without MnDPDP and CT or between T2 weighted images and CT. Conclusion. Magnetic resonance imaging with MnDPDP is significantly more sensitive than unenhanced MRI and helical CT for the follow-up of liver lesions.