Diagnostic Performance of Abbreviated MRI Protocol for Colorectal Liver Metastasis Compared to Dynamic MRI Protocol

Abstract Background Colorectal cancer is the 7th commonest cancer in Egypt, representing 3.47% of male cancers and 3% of female cancers. New treatments and the technological improvements of imaging increase the detection of secondary lesions and consequently improve the survival of these patients. Imaging is an important tool in the management of patients with liver metastases by evaluating and following up the lesions regarding the number, size, site and assessing the resectability. Ultrasound and contrast-enhanced computed tomography (CECT) were the first-line imaging tools for the assessment of metastatic liver lesions. However, these modalities have a low sensitivity and specificity for the detection and characterization of liver lesions. These limitations have paved the way for contrast-enhanced magnetic resonance imaging (CE-MRI), which has now become the modality of choice in triaging patients with suspected colorectal liver metastasis. Abbreviated MRI protocols have emerged as an alternative to standard MRI protocols thus eliminating unnecessary sequences that increase the cost, MRI table time, patient discomfort, and image interpretation time. However, the diagnostic competency is not generally compromised. The purpose of our study is to assess whether an Abbreviated MRI protocol consisting of DWI and T2-W fat- suppressed (FS) sequence has a similar lesion detection performance compared with standard gadoxetic acid–enhanced MRI protocol for colorectal liver metastasis surveillance. Results we found in our study that in the detection of hepatic metastasis in colorectal cancer, abbreviated protocol showed 92.86% sensitivity, 93.55% specificity, 86.67% PPV, 96.67% NPV, and 93.33% overall accuracy. Also, the complete protocol showed 100% sensitivity, 96.8% specificity, 93.3% PPV, 100% NPV, and 97.8% overall accuracy. Conclusions A comparison between abbreviated and complete protocols showed in the detection of hepatic metastasis in colorectal cancer that the complete protocol had higher sensitivity, specificity, PPV, NPV, and accuracy than the abbreviated protocol. However, these differences did not reach a significant level (p > 0.05).