Screening for synchronous metastases in colorectal cancer using hepatic diffusion weighted MRI.
Over half of all patients diagnosed with colorectal cancer have a high-risk tumour. Patients with high-risk tumours are more likely to have disease which has spread to the liver, this is called liver metastases, when the colorectal cancer is diagnosed. In order to effectively treat and therefore cure these patients identification is essential.
At present patients undergo a CT scan but it is difficult to diagnose liver metastases using a conventional CT scan. MRI is known to be better but takes a long time. Recently it has been suggested that limited MRI of the liver can identify most metastases but this has not yet been proven to be effective in patients with a new diagnosis of colorectal cancer.
This study, headed by Dr Anita Wale at the Royal Marsden, will test whether a quick MRI scan of the liver at the time of colorectal cancer diagnosis can identify more liver metastases than conventional CT. This research could potentially mean that more patients are intensively and effectively treated for their liver metastases, improving patient outcomes.
References
Eiber M et al. Detection and classification of focal liver lesions in patients with colorectal cancer: retrospective comparison of diffusion-weighted MR imaging and multi-slice CT. Eur J Radiol. Apr 2012;81(4):683-691.
Hunter CJ et al. Adverse features on rectal MRI identify a high-risk group that may benefit from more intensive preoperative staging and treatment. Ann Surg Oncol. Apr 2012;19(4):1199-1205.
Niekel MC et al. 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. Dec 2010;257(3):674-684.