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Ryu HS, Kim HJ, Ji WB, Kim BC, Kim JH, Moon SK, Kang SI, Kwak HD, Kim ES, Kim CH, Kim TH, Noh GT, Park BS, Park HM, Bae JM, Bae JH, Seo NE, Song CH, Ahn MS, Eo JS, Yoon YC, Yoon JK, Lee KH, Lee KH, Lee KY, Lee MS, Lee SH, Lee JM, Lee JE, Lee HH, Ihn MH, Jang JH, Jeon SK, Chae KJ, Choi JH, Pyo DH, Ha GW, Han KS, Hong YK, Hong CW, Kwak JM. Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment. Ann Coloproctol 2024; 40:89-113. [PMID: 38712437 PMCID: PMC11082542 DOI: 10.3393/ac.2024.00059.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 05/08/2024] Open
Abstract
Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients' values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.
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Affiliation(s)
- Hyo Seon Ryu
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Institute for Evidence-based Medicine, Cochrane Collaboration, Seoul, Korea
| | - Woong Bae Ji
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University Ansan Hospital, Ansan, Korea
| | - Byung Chang Kim
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
| | - Ji Hun Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Kyung Moon
- Department of Radiology, Kyung Hee University Hospital, Seoul, Korea
| | - Sung Il Kang
- Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea
| | - Han Deok Kwak
- Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Eun Sun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Chang Hyun Kim
- Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Tae Hyung Kim
- Department of Radiation Oncology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Gyoung Tae Noh
- Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea
| | - Byung-Soo Park
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Hyeung-Min Park
- Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Jeong Mo Bae
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
| | - Jung Hoon Bae
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ni Eun Seo
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Hoon Song
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mi Sun Ahn
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - Jae Seon Eo
- Department of Nuclear Medicine and Molecular Imaging, Korea University College of Medicine, Seoul, Korea
| | - Young Chul Yoon
- Department of General Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
| | - Kyung Ha Lee
- Department of Surgery, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
| | - Kyung Hee Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kil-Yong Lee
- Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Myung Su Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Sung Hak Lee
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Min Lee
- Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Ji Eun Lee
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Han Hee Lee
- Division of Gastroenterology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Myong Hoon Ihn
- Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Je-Ho Jang
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
| | - Sun Kyung Jeon
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Kum Ju Chae
- Department of Radiology, Jeonbuk National University Medical School, Jeonju, Korea
| | - Jin-Ho Choi
- Center for Lung Cancer, Department of Thoracic Surgery, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Dae Hee Pyo
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gi Won Ha
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Kyung Su Han
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
| | - Young Ki Hong
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Chang Won Hong
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
| | - Jung-Myun Kwak
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Korean Colon Cancer Multidisciplinary Committee
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Institute for Evidence-based Medicine, Cochrane Collaboration, Seoul, Korea
- Division of Colon and Rectal Surgery, Department of Surgery, Korea University Ansan Hospital, Ansan, Korea
- Center for Colorectal Cancer, National Cancer Center, Goyang, Korea
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Radiology, Kyung Hee University Hospital, Seoul, Korea
- Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea
- Department of Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
- Department of Radiation Oncology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
- Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
- Department of Nuclear Medicine and Molecular Imaging, Korea University College of Medicine, Seoul, Korea
- Department of General Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
- Department of Surgery, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
- Division of Gastroenterology, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea
- Department of Radiology, Jeonbuk National University Medical School, Jeonju, Korea
- Center for Lung Cancer, Department of Thoracic Surgery, Research Institute and Hospital, National Cancer Center, Goyang, Korea
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
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Elahi N, Rizwan M. Progress and prospects of magnetic iron oxide nanoparticles in biomedical applications: A review. Artif Organs 2021; 45:1272-1299. [PMID: 34245037 DOI: 10.1111/aor.14027] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/09/2021] [Accepted: 06/14/2021] [Indexed: 12/26/2022]
Abstract
Nanoscience has been considered as one of the most substantial research in modern science. The utilization of nanoparticle (NP) materials provides numerous advantages in biomedical applications due to their unique properties. Among various types of nanoparticles, the magnetic nanoparticles (MNPs) of iron oxide possess intrinsic features, which have been efficiently exploited for biomedical purposes including drug delivery, magnetic resonance imaging, Magnetic-activated cell sorting, nanobiosensors, hyperthermia, and tissue engineering and regenerative medicine. The size and shape of nanostructures are the main factors affecting the physicochemical features of superparamagnetic iron oxide nanoparticles, which play an important role in the improvement of MNP properties, and can be controlled by appropriate synthesis strategies. On the other hand, the proper modification and functionalization of the surface of iron oxide nanoparticles have significant effects on the improvement of physicochemical and mechanical features, biocompatibility, stability, and surface activity of MNPs. This review focuses on popular methods of fabrication, beneficial surface coatings with regard to the main required features for their biomedical use, as well as new applications.
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Affiliation(s)
- Narges Elahi
- Department of Tissue Engineering and Applied Cell Sciences, School of Advance Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Fasa University of Medical Sciences, Fasa, Iran.,Department of Medical Nanotechnology, School of Advance Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Muhammad Rizwan
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, ON, Canada
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Suto DJ, Nair G, Sudarshana DM, Steele SU, Dwyer J, Beck ES, Ohayon J, McFarland H, Koretsky AP, Cortese ICM, Reich DS. Manganese-Enhanced MRI in Patients with Multiple Sclerosis. AJNR Am J Neuroradiol 2020; 41:1569-1576. [PMID: 32763897 DOI: 10.3174/ajnr.a6665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 05/31/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND PURPOSE Cellular uptake of the manganese ion, when administered as a contrast agent for MR imaging, can noninvasively highlight cellular activity and disease processes in both animals and humans. The purpose of this study was to explore the enhancement profile of manganese in patients with multiple sclerosis. MATERIALS AND METHODS Mangafodipir is a manganese chelate that was clinically approved for MR imaging of liver lesions. We present a case series of 6 adults with multiple sclerosis who were scanned at baseline with gadolinium, then injected with mangafodipir, and followed at variable time points thereafter. RESULTS Fourteen new lesions formed during or shortly before the study, of which 10 demonstrated manganese enhancement of varying intensity, timing, and spatial pattern. One gadolinium-enhancing extra-axial mass, presumably a meningioma, also demonstrated enhancement with manganese. Most interesting, manganese enhancement was detected in lesions that formed in the days after mangafodipir injection, and this enhancement persisted for several weeks, consistent with contrast coming from intracellular uptake of manganese. Some lesions demonstrated a diffuse pattern of manganese enhancement in an area larger than that of both gadolinium enhancement and T2-FLAIR signal abnormality. CONCLUSIONS This work demonstrates the first use of a manganese-based contrast agent to enhance MS lesions on MR imaging. Multiple sclerosis lesions were enhanced with a temporal and spatial profile distinct from that of gadolinium. Further experiments are necessary to uncover the mechanism of manganese contrast enhancement as well as cell-specific uptake.
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Affiliation(s)
- D J Suto
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - G Nair
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - D M Sudarshana
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - S U Steele
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - J Dwyer
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - E S Beck
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - J Ohayon
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - H McFarland
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - A P Koretsky
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - I C M Cortese
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - D S Reich
- From the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
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Caraiani CN, Dan M, Fenesan DI, Badea R. Description of focal liver lesions with Gd-EOB-DTPA enhanced MRI. Med Pharm Rep 2016; 88:438-48. [PMID: 26733231 PMCID: PMC4689233 DOI: 10.15386/cjmed-414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 07/31/2015] [Indexed: 11/23/2022] Open
Abstract
Imaging procedures play a fundamental role in the therapeutic management of focal liver lesions. The goals of imaging are to detect and correctly characterize focal liver lesions. This review highlights the performances of newer, liver-specific, contrast media in the diagnosis of focal liver lesions, particularly Gd-EOB-DTPA (Primovist), the most frequently used liver specific contrast media. It has been shown, in different papers, that Gd-EOB-DTPA has better performances compared to either triphasic contrast enhanced computed tomography or dynamic MRI in both detection and characterization of hepatocellular carcinoma on the cirrhotic liver. Therefore liver MRI with Primovist is considered, in many centers, the "state-of-the-art" imaging examination of the liver before surgery or liver transplantation. Gd-EOB-DTPA is also useful in the differential diagnosis of benign hypervascular focal liver lesions such as adenomas or focal nodular hyperplasias.
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Affiliation(s)
- Cosmin-Nicolae Caraiani
- Department of Medical Imaging, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Marian Dan
- Department of Medical Imaging, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Diana-Ioana Fenesan
- Department of Medical Imaging, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Badea
- Department of Ultrasonography/Medical Imaging, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Cantisani V, Grazhdani H, Fioravanti C, Rosignuolo M, Calliada F, Messineo D, Bernieri MG, Redler A, Catalano C, D’Ambrosio F. Liver metastases: Contrast-enhanced ultrasound compared with computed tomography and magnetic resonance. World J Gastroenterol 2014; 20:9998-10007. [PMID: 25110428 PMCID: PMC4123379 DOI: 10.3748/wjg.v20.i29.9998] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 11/23/2013] [Accepted: 04/29/2014] [Indexed: 02/06/2023] Open
Abstract
The development of ultrasound contrast agents with excellent tolerance and safety profiles has notably improved liver evaluation with ultrasound (US) for several applications, especially for the detection of metastases. In particular, contrast enhanced ultrasonography (CEUS) allows the display of the parenchymal microvasculature, enabling the study and visualization of the enhancement patterns of liver lesions in real time and in a continuous manner in all vascular phases, which is similar to contrast-enhanced computed tomography (CT) and contrast-enhanced magnetic resonance imaging. Clinical studies have reported that the use of a contrast agent enables the visualization of more metastases with significantly improved sensitivity and specificity compared to baseline-US. Furthermore, studies have shown that CEUS yields sensitivities comparable to CT. In this review, we describe the state of the art of CEUS for detecting colorectal liver metastases, the imaging features, the literature reports of metastases in CEUS as well as its technique, its clinical role and its potential applications. Additionally, the updated international consensus panel guidelines are reported in this review with the inherent limitations of this technique and best practice experiences.
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Burke C, Alexander Grant L, Goh V, Griffin N. The role of hepatocyte-specific contrast agents in hepatobiliary magnetic resonance imaging. Semin Ultrasound CT MR 2013; 34:44-53. [PMID: 23395317 DOI: 10.1053/j.sult.2012.11.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Hepatocyte-specific contrast agents have been made available in the last 15 years for magnetic resonance imaging of the liver. These agents are differentially taken up by functioning hepatocytes and excreted in the biliary system. They can help distinguish focal liver lesions of hepatocellular origin from lesions of nonhepatocellular origin, and can also be used in the evaluation of the biliary tree. The purpose of this review is to summarize the different types of hepatocyte-specific contrast agents presently available, their use in the characterization of focal liver lesions, their role in the evaluation of biliary pathology, and their potential future applications.
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Affiliation(s)
- Chistopher Burke
- Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, UK
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Kantarcı M, Pirimoglu B, Karabulut N, Bayraktutan U, Ogul H, Ozturk G, Aydinli B, Kizrak Y, Eren S, Yilmaz S. Non-invasive detection of biliary leaks using Gd-EOB-DTPA-enhanced MR cholangiography: comparison with T2-weighted MR cholangiography. Eur Radiol 2013; 23:2713-22. [PMID: 23695221 PMCID: PMC3769590 DOI: 10.1007/s00330-013-2880-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 03/20/2013] [Accepted: 03/24/2013] [Indexed: 02/07/2023]
Abstract
Objective To evaluate the added role of T1-weighted (T1w) gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance cholangiography (MRC) compared with T2-weighted MRC (T2w-MRC) in the detection of biliary leaks. Methods Ninety-nine patients with suspected biliary complications underwent routine T2w-MRC and T1w contrast-enhanced (CE) MRC using Gd-EOB-DTPA to identify biliary leaks. Two observers reviewed the image sets separately and together. MRC findings were compared with those of surgery and percutaneous transhepatic cholangiopancreatography. The sensitivity, specificity and accuracy of the techniques in identifying biliary leaks were calculated. Results Accuracy of locating biliary leaks was superior with the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC (P < 0.05).The mean sensitivities were 79 % vs 59 %, and the mean accuracy rates were 84 % vs 58 % for combined CE-MRC and T2w-MRC vs sole T2w-MRC. Nineteen out of 21 patients with biliary-cyst communication, 90.4 %, and 12/15 patients with post-traumatic biliary extravasations, 80 %, were detected by the combination of Gd-EOB-DTPA-enhanced MRC and T2w-MRC images, P < 0.05. Conclusions Gd-EOB-DTPA-enhanced MRC yields information that complements T2w-MRC findings and improves the identification and localisation of the bile extravasations (84 % accuracy, 100 % specificity, P < 0.05). We recommend Gd-EOB-DTPA-enhanced MRC in addition to T2w-MRC to increase the preoperative accuracy of identifying and locating extravasations of bile. Key Points • Magnetic resonance cholangiography (MRC) does not always detect bile leakage and cysto-biliary communications. • Gd-EOB-DTPA-enhanced MRC helps by demonstrating extravasation of contrast material into fluid collections. • Gd-EOB-DTPA-enhanced MRC also demonstrates the leakage site and bile duct injury type. • Combined Gd-EOB-DTPA-enhanced and T2w-MRC can provide comprehensive information about biliary system. • Gd-EOB-DTPA-enhanced MRC is non-invasive and does not use ionising radiation.
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Affiliation(s)
- Mecit Kantarcı
- School of Medicine, Department of Radiology, Atatürk University, Erzurum, Turkey,
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Fe3O4/MnO hybrid nanocrystals as a dual contrast agent for both T1- and T2-weighted liver MRI. Biomaterials 2013; 34:2069-76. [DOI: 10.1016/j.biomaterials.2012.11.054] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 11/27/2012] [Indexed: 11/20/2022]
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Abstract
Treatment of HCC is complicated by its highly variable biologic behavior and the frequent coexistence of chronic liver disease and cirrhosis in affected patients. While surgery remains the most frequently employed treatment modality, curative resection is only possible for a minority of patients. More often, treatment goals are palliative and draw on the expertise of a range of medical specialists. This chapter aims to place current treatment strategies within the framework of a multidisciplinary approach with special emphasis on pretreatment evaluation, staging, and the selection of an appropriate treatment strategy.
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Kim HJ, Kim BS, Kim MJ, Kim SH, de Campos ROP, Hernandes M, Semelka RC. Enhancement of the liver and pancreas in the hepatic arterial dominant phase: comparison of hepatocyte-specific MRI contrast agents, gadoxetic acid and gadobenate dimeglumine, on 3 and 1.5 Tesla MRI in the same patient. J Magn Reson Imaging 2012; 37:903-8. [PMID: 23065959 DOI: 10.1002/jmri.23874] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 09/11/2012] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To evaluate the relative enhancement of liver, pancreas, focal nodular hyperplasia (FNH), pancreas-to-liver index, and FNH-to-liver index in the hepatic arterial dominant phase (HADP) after injection of hepatocyte-specific MRI contrast agents, gadoxetic acid and gadobenate dimeglumine, on 3 and 1.5 Tesla (T) MRI in the same patient. MATERIALS AND METHODS The MRI database was retrospectively searched to identify consecutive patients who underwent abdominal MRI at 3T and 1.5T systems, using both 0.025 mmol/kg gadoxetic acid-enhanced and 0.05 mmol/kg gadobenate dimeglumine-enhanced MRI at the same magnetic strength field system. 22 patients were identified, 10 were scanned at 3T system and 12 at 1.5T system. The enhancement of liver, pancreas, and FNH was evaluated quantitatively on MR images. RESULTS The relative enhancement of liver in HADP in the gadobenate dimeglumine-enhanced group in all subjects was significantly higher than that in gadoxetic acid-enhanced group (P = 0.023). The gadobenate dimeglumine-enhanced group in HADP had better relative enhancement of pancreas and FNH, pancreas-to-liver index, and FNH-to-liver index than gadoxetic acid-enhanced group, but the difference was not statistically significant. CONCLUSION The 0.05 mmol/kg gadobenate dimeglumine-enhanced abdominal MRI studies at 3T and 1.5T MR systems are superior in relative enhancement of the liver in HADP to 0.025 mmol/kg gadoxetic acid-enhanced MRI. This type of assessment may provide comparative effectiveness data.
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Affiliation(s)
- Hee Jin Kim
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7510, USA
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Muhi A, Ichikawa T, Motosugi U, Sou H, Nakajima H, Sano K, Sano M, Kato S, Kitamura T, Fatima Z, Fukushima K, Iino H, Mori Y, Fujii H, Araki T. Diagnosis of colorectal hepatic metastases: Comparison of contrast-enhanced CT, contrast-enhanced US, superparamagnetic iron oxide-enhanced MRI, and gadoxetic acid-enhanced MRI. J Magn Reson Imaging 2011; 34:326-35. [DOI: 10.1002/jmri.22613] [Citation(s) in RCA: 123] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Niekel MC, Bipat S, Stoker J. Diagnostic Imaging of Colorectal Liver Metastases with CT, MR Imaging, FDG PET, and/or FDG PET/CT: A Meta-Analysis of Prospective Studies Including Patients Who Have Not Previously Undergone Treatment. Radiology 2010; 257:674-84. [DOI: 10.1148/radiol.10100729] [Citation(s) in RCA: 420] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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13
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Assessment of liver metastases from colorectal adenocarcinoma following chemotherapy: SPIO-MRI versus FDG-PET/CT. Radiol Med 2010; 115:1087-100. [PMID: 20574703 DOI: 10.1007/s11547-010-0560-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2009] [Accepted: 11/27/2009] [Indexed: 01/06/2023]
Abstract
PURPOSE This study compared superparamagnetic iron-oxide-enhanced magnetic resonance imaging (SPIO-MRI) and combined fluorodeoxyglucose positron emission tomography and computed tomography (FDG-PET/CT) in evaluating liver metastases from colorectal adenocarcinoma following chemotherapy. MATERIALS AND METHODS Nineteen patients were included in this retrospective study. SPIO-MRI and PET/CT results were compared with surgery, intraoperative ultrasound and pathology results in 11 patients and with the follow-up in eight patients. RESULTS SPIO-MRI and PET/CT identified 125 and 71 metastases, respectively. False negative lesions were 11 for SPIO-MRI and 65 for PET/CT. In the whole study population, the per-lesion analysis of SPIO-MRI and PET/CT showed a sensitivity of 92% and 52% (p<0.001) and the per-segment analysis a sensitivity of 99% and 79% (p<0.001), respectively. In patients who underwent surgery, the per-lesion analysis of SPIO-MRI and PET/CT showed a sensitivity of 85% and 58% (p<0.05) and the per-segment analysis a sensitivity of 97% and 63% (p<0.05), respectively. In patients who underwent follow-up, the per-lesion analysis of SPIO-MRI and PET/CT showed a sensitivity of 97% and 47% (p<0.001) and the per-segment analysis a sensitivity of 100% and 63% (p<0.007), respectively. For lesions ≥15 and <30 mm and for lesions <15 mm, SPIO-MRI demonstrated a higher sensitivity than PET/CT (p<0.001). CONCLUSIONS SPIO-MRI appears superior to PET/CT in evaluating liver metastases from colorectal adenocarcinoma following chemotherapy.
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Vauthey JN, Dixon E, Abdalla EK, Helton WS, Pawlik TM, Taouli B, Brouquet A, Adams RB. Pretreatment assessment of hepatocellular carcinoma: expert consensus statement. HPB (Oxford) 2010; 12:289-99. [PMID: 20590901 PMCID: PMC2951814 DOI: 10.1111/j.1477-2574.2010.00181.x] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Staging of hepatocellular carcinoma (HCC) is complex and relies on multiple factors including tumor extent and hepatic function. No single staging system is applicable to all patients with HCC. The staging of the American Joint Committee on Cancer / International Union for Cancer Control should be used to predict outcome following resection or liver transplantation. The Barcelona Clinic Liver Cancer scheme is appropriate in patients with advanced HCC not candidate for surgery. Dual phase computed tomography or magnetic resonance imaging can be used for pretreatment assessment of tumor extent but the accuracy of these methods remains poor to characterize < 1 cm lesions. Assessment of tumor response should not rely only on tumor size and new imaging methods are available to evaluate response to therapy in HCC patients. Liver volumetry is part of the preoperative assessment of patients with HCC candidate for resection as it reflects liver function. Preoperative portal vein embolization is indicated in patients with small future liver remnant (≤ 20% in normal liver; ≤ 40% in fibrotic or cirrhotic liver). Tumor size is not a contraindication to liver resection. Liver resection can be proposed in selected patients with multifocal HCC. Besides tumor extent, surgical resection of HCC may be performed in selected patients with chronic liver disease.
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Affiliation(s)
- Jean-Nicolas Vauthey
- Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer CenterHouston, TX, USA
| | - Elijah Dixon
- Department of Surgery, University of CalgaryCalgary, Canada
| | - Eddie K Abdalla
- Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer CenterHouston, TX, USA
| | - W Scott Helton
- Department of Surgery, Hospital of Saint RaphaelNew Haven, CT
| | - Timothy M Pawlik
- Department of Surgery, The Johns Hopkins University School of MedicineBaltimore, MD
| | - Bachir Taouli
- Department of Radiology, Mount Sinai School of MedicineNew York, NY
| | - Antoine Brouquet
- Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer CenterHouston, TX, USA
| | - Reid B Adams
- Department of Surgery, University of Virginia Health SystemCharlottesville, VA, USA
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Seale MK, Catalano OA, Saini S, Hahn PF, Sahani DV. Hepatobiliary-specific MR contrast agents: role in imaging the liver and biliary tree. Radiographics 2010; 29:1725-48. [PMID: 19959518 DOI: 10.1148/rg.296095515] [Citation(s) in RCA: 276] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hepatobiliary-specific contrast agents are one of several classes of contrast agents available for magnetic resonance (MR) imaging of the liver. These agents are taken up by functioning hepatocytes and excreted in the bile, and their paramagnetic properties cause shortening of the longitudinal relaxation time (T1) of the liver and biliary tree. The three contrast agents that have been developed are mangafodipir trisodium (Mn-DPDP), gadobenate dimeglumine (Gd-BOPTA), and gadoxetic acid (Gd-EOB-DTPA). These three MR contrast agents vary in mode of administration and dose, mechanism of cellular uptake, degree of excretion through the biliary pathway, and imaging characteristics. In the liver, hepatobiliary-specific agents can be used to improve lesion detection, to characterize lesions as hepatocellular or nonhepatocellular, and to specifically characterize some hepatocellular lesions, notably focal nodular hyperplasia. Biliary excretion of these agents can be used to evaluate the anatomic structure and function of the biliary tree. In the future, hepatobiliary-specific contrast agents may have wider applications, such as grading of cirrhosis and quantification of liver function.
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Affiliation(s)
- Melanie K Seale
- Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, White 270, 55 Fruit St, Boston, MA 02114, USA
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16
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Sakamoto JH, van de Ven AL, Godin B, Blanco E, Serda RE, Grattoni A, Ziemys A, Bouamrani A, Hu T, Ranganathan SI, De Rosa E, Martinez JO, Smid CA, Buchanan RM, Lee SY, Srinivasan S, Landry M, Meyn A, Tasciotti E, Liu X, Decuzzi P, Ferrari M. Enabling individualized therapy through nanotechnology. Pharmacol Res 2010; 62:57-89. [PMID: 20045055 DOI: 10.1016/j.phrs.2009.12.011] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2009] [Accepted: 12/21/2009] [Indexed: 12/13/2022]
Abstract
Individualized medicine is the healthcare strategy that rebukes the idiomatic dogma of 'losing sight of the forest for the trees'. We are entering a new era of healthcare where it is no longer acceptable to develop and market a drug that is effective for only 80% of the patient population. The emergence of "-omic" technologies (e.g. genomics, transcriptomics, proteomics, metabolomics) and advances in systems biology are magnifying the deficiencies of standardized therapy, which often provide little treatment latitude for accommodating patient physiologic idiosyncrasies. A personalized approach to medicine is not a novel concept. Ever since the scientific community began unraveling the mysteries of the genome, the promise of discarding generic treatment regimens in favor of patient-specific therapies became more feasible and realistic. One of the major scientific impediments of this movement towards personalized medicine has been the need for technological enablement. Nanotechnology is projected to play a critical role in patient-specific therapy; however, this transition will depend heavily upon the evolutionary development of a systems biology approach to clinical medicine based upon "-omic" technology analysis and integration. This manuscript provides a forward looking assessment of the promise of nanomedicine as it pertains to individualized medicine and establishes a technology "snapshot" of the current state of nano-based products over a vast array of clinical indications and range of patient specificity. Other issues such as market driven hurdles and regulatory compliance reform are anticipated to "self-correct" in accordance to scientific advancement and healthcare demand. These peripheral, non-scientific concerns are not addressed at length in this manuscript; however they do exist, and their impact to the paradigm shifting healthcare transformation towards individualized medicine will be critical for its success.
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Affiliation(s)
- Jason H Sakamoto
- The University of Texas Health Science Center, Department of Nanomedicine and Biomedical Engineering, Houston, TX 77030, USA
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17
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Mainenti PP, Mancini M, Mainolfi C, Camera L, Maurea S, Manchia A, Tanga M, Persico F, Addeo P, D'Antonio D, Speranza A, Bucci L, Persico G, Pace L, Salvatore M. Detection of colo-rectal liver metastases: prospective comparison of contrast enhanced US, multidetector CT, PET/CT, and 1.5 Tesla MR with extracellular and reticulo-endothelial cell specific contrast agents. ACTA ACUST UNITED AC 2009; 35:511-21. [PMID: 19562412 DOI: 10.1007/s00261-009-9555-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Accepted: 06/11/2009] [Indexed: 02/06/2023]
Abstract
BACKGROUND To compare contrast-enhanced US (CE-US), multidetector-CT (MDCT), 1.5 Tesla MR with extra-cellular (Gd-enhanced) and intracellular (SPIO-enhanced) contrast agents and PET/CT, in the detection of hepatic metastases from colorectal cancer. MATERIALS AND METHODS A total of 34 patients with colo-rectal adenocarcinoma underwent preoperatively CE-US, MDCT, Gd- and SPIO-enhanced MR imaging (MRI), and PET/CT. Each set of images was reviewed independently by two blinded observers. The ROC method was used to analyze the results, which were correlated with surgical findings, intraoperative US, histopathology, and MDCT follow-up. RESULTS A total of 57 hepatic lesions were identified: 11 hemangiomas, 29 cysts, 1 focal fatty liver, 16 metastases (dimensional distribution: 5/16 < 5 mm; 3/16 between 5 mm and <10 mm; 8/16 ≥ 10 mm). Six of 34 patients were classified as positive for the presence of at least one metastasis. Considering all the metastases and those ≥ 10 mm, ROC areas showed no significant differences between Gd- and SPIO-enhanced MRI, which performed significantly better than the other modalities (P < 0.05). Considering the lesions <10 mm, ROC areas showed no significant differences between all modalities; however MRI presented a trend to perform better than the other techniques. Considering the patients, ROC areas showed no significant differences between all the modalities; however PET/CT seemed to perform better than the others. CONCLUSIONS Gd- and SPIO-enhanced MRI seem to be the most accurate modality in the identification of liver metastases from colo-rectal carcinoma. PET/CT shows a trend to perform better than the other modalities in the identification of patients with liver metastases.
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18
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Morana G, Cugini C, Mucelli RP. Small liver lesions in oncologic patients: characterization with CT, MRI and contrast-enhanced US. Cancer Imaging 2008; 8 Spec No A:S132-5. [PMID: 18852087 PMCID: PMC2582502 DOI: 10.1102/1470-7330.2008.9020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Focal liver lesions (FLLs) are frequently discovered during ultrasound examinations either in healthy subjects without a clinical history of cancer or during staging or follow-up procedures in oncologic patients or in routine surveillance of hepatopathic patients. In oncologic patients, the liver is the most common target of metastatic disease and accurate detection and characterisation of FLLs is prognostically fundamental during the initial staging as well as before and after pre-operative chemotherapy, as it can help to identify patients who are most likely to benefit from liver surgery. Moreover, early detection of primary or secondary liver malignancies increases the possibility of curative surgical resection or successful percutaneous ablation. As many FLLs in these patients are benign, a precise and preferably non-invasive method of differentiation from malignant metastatic nodules is needed. Moreover, the continuous follow-up of cancer patients requires an easily available, reliable and cost-effective diagnostic tool for the detection and characterization of FLLs.
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Affiliation(s)
- Giovanni Morana
- Radiological Department, General Hospital Cá Foncello, Piazza Ospedale 1, 31100 Treviso, Italy.
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Abstract
For most solid neoplasms, medical imaging is a vital component of tumor staging and surveillance. Imaging strategies vary according to the type and grade of primary neoplasm, tumor stage at diagnosis, tumor markers, previous therapies, and patient symptoms. In this article, we address imaging of individual organs (lung, liver, adrenals) and outline imaging strategies for specific types of neoplasms.
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Affiliation(s)
- Donald L Klippenstein
- State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, NY 14214, USA.
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20
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Rappeport ED, Loft A. Liver metastases from colorectal cancer: imaging with superparamagnetic iron oxide (SPIO)-enhanced MR imaging, computed tomography and positron emission tomography. ACTA ACUST UNITED AC 2008; 32:624-34. [PMID: 17710359 DOI: 10.1007/s00261-007-9297-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The literature about superparamagnetic iron oxide-enhanced MR imaging, computed tomography (CT) and PET (positron emission tomography using fluorine-18 labelled fluoro-deoxy-glucose) in detection of liver metastases (LM) from colorectal cancer is reviewed in this update. Special emphasis is given to studies with surgical standard of reference allowing for the lesion-by-lesion sensitivity to be determined. Based on the review, it is concluded that state-of-the-art anatomical imaging, e.g., SPIO-enhanced MR imaging and multidetector CT (MDCT), must be considered more sensitive than PET in detection of individual LM, due to technical developments in MR imaging, such as liver specific contrast agents, modern sequences and high performance gradients, and in modern MDCT have increased the performance of these modalities. MR imaging with a liver specific contrast agent is recommended for the preoperative evaluation before liver surgery for LM because of high sensitivity and better discrimination between small LM and cysts compared to MDCT. PET or PET/CT can be used for detection of extra-hepatic tumor before liver surgery.
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Affiliation(s)
- Eli D Rappeport
- Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
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22
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Zech CJ, Herrmann KA, Reiser MF, Schoenberg SO. MR imaging in patients with suspected liver metastases: value of liver-specific contrast agent Gd-EOB-DTPA. Magn Reson Med Sci 2007; 6:43-52. [PMID: 17510541 DOI: 10.2463/mrms.6.43] [Citation(s) in RCA: 221] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The appropriate staging of malignant tumors is increasingly important as new therapeutic strategies develop. Because metastatic involvement of the liver in extrahepatic malignant disease may significantly change therapeutic approach, it is important to rule out such involvement with high confidence. Moreover, the differentiation between incidental benign lesions, such as hemangioma, focal nodular hyperplasia (FNH), or adenoma, is of high interest. Magnetic resonance (MR) imaging has proved reliable for diagnostic work-up of the liver. Liver-specific contrast agents have been especially helpful in detecting and precisely characterizing focal liver lesions, but the use of these agents has been limited because it has not been possible to perform both proper vascular phase and liver-specific phase within a reasonable time frame and in a single examination after a single injection of contrast agent. However, the hepatobiliary contrast agent gadolinium-ethoxybenzyl (Gd-EOB)-DTPA now allows combined dynamic imaging and hepatocyte-specific imaging in one examination. Gd-EOB-DTPA can be injected as a bolus and shows the enhancement characteristics and vascularity of liver lesions. In the delayed phase, which is acquired most appropriately 20 min after injection, Gd-EOB-DTPA is taken up selectively by functioning hepatocytes. Thus, malignant liver lesions, e.g. metastases, are spared from contrast uptake of the surrounding liver parenchyma. These lesions are hypointense in contrast to the surrounding bright liver. We review the current literature and present a practical approach to Gd-EOB-enhanced MR imaging using imaging examples of patients with liver metastases.
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Affiliation(s)
- Christoph J Zech
- Institute of Clinical Radiology, Munich University Hospitals-Grosshadern, Ludwig-Maximilians-University.
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Abstract
With improvements in therapy for colorectal cancer, accurate imaging has taken on an increased significance. Preoperative diagnosis of metastatic disease helps identify patients who could undergo combined resection or might benefit from systemic therapy before surgery. Accurate imaging of rectal cancer is critical in evaluating locally advanced disease treatable by combined modality therapy, including chemoradiation and surgery. Postoperative imaging enhances identification of recurrent disease that might be amenable to salvage surgery.
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Affiliation(s)
- Carl R Schmidt
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
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