Background: Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has shown to be superior to contrast-enhanced computed tomography (CT) in studies, there is no adequate data on its impact on overall survival and recurrence-free survival in patients with colorectal liver metastasis. Our objective was to study the benefit afforded by gadoxetic acid-enhanced MRI in patients with colorectal liver metastasis, especially in terms of overall survival and recurrence-free survival.
Methods: Patients who underwent surgical treatment for colorectal liver metastasis between January 2003 and December 2018 were divided into groups depending on the pro-operative imaging carried out. Overall survival and recurrence-free survival were compared between both groups.
Results: Totally, 480 cases were included. Gadoxetic acid-enhanced MRI detected 220 new lesions in 123 cases. Presence of metastatic nodules was confirmed by gadoxetic acid-enhanced MRI in 33 of the 55 patients (60.0%) with indeterminate nodules on contrast-enhanced CT. Gadoxetic acid-enhanced MRI detected significantly more nodules than contrast-enhanced CT (932 vs. 673, respectively, P<0.001). There was no difference in the 5-year overall survival (P=0.390) or in the 3-month (85.1% vs. 86.7%, respectively, P=0.790), 6-month (78.0% vs. 81.7%, respectively, P=0.570), or 1-year (65.7% vs. 69.6%, respectively, P=0.446) recurrence-free survival in patients examined with contrast-enhanced CT or gadoxetic acid-enhanced MRI.
Conclusions: Although gadoxetic acid-enhanced MRI is more sensitive than contrast-enhanced CT, its utilization does not significantly affect the recurrence-free survival of the patient.
Keywords: Disappearing liver metastasis (DLM); colorectal cancer (CRC); gadoxetic acid-enhanced magnetic resonance imaging (gadoxetic acid-enhanced MRI); indeterminate nodules; neoadjuvant chemotherapy.