Magnetic Resonance Imaging or Contrast-Enhanced Computed Tomography of the
Liver as Standard Workup Before Treatment for Rectal Cancer
Mathias Utterberg, Degree Project in Medicine, 2018
Department of Surgery, Sahlgrenska Academy, University of Gothenburg, Sweden
Supervisor: Eva Haglind
Introduction: The liver is the most commonly affected site regarding rectal cancer
metastasis. The Swedish national cancer care guidelines recommend a routine of a
preoperative contrast-enhanced computed tomography (CT) to examine the liver for
metastases before rectal cancer treatment. The NU Hospital Group (NU) conforms to the
national guidelines. The Sahlgrenska University Hospital (SU) differs by conducting
magnetic resonance imaging (MRI) of the liver.
Objective: To compare the efficiency of MRI with contrast-enhanced CT as the index
examination of the liver in patients with newly diagnosed rectal cancer.
Methods: Clinical data regarding 320 patients with rectal cancer (160 from SU and 160 from
NU) were collected from the Regional ColoRectal Cancer Register, 2013–2015. Information
regarding such as liver examinations and surgery was collected from hospital records. All
index liver examinations that did not confirm or rule out liver metastasis were considered
“inconclusive” and subsequently re-evaluated by two radiologists.
Results: 274 patients were analyzed. 13 % in the MRI group and 15 % in the CT group
underwent supplementary liver examinations before treatment for rectal cancer (p = 0.635).
Within 18 months after the index examination, a total of 17 % of patients were diagnosed
with liver metastases in both groups combined (p = 0.765), and 8 % of patients in the MRI
group versus 2 % in the CT group were treated with liver surgery (p = 0.016).
Conclusions: MRI did not show any clinical advantage over contrast-enhanced CT as the
index examination of the liver among patients with newly diagnosed rectal cancer. Thus, this
study gives no reason to change the current Swedish national guidelines for rectal cancer.||sv
|dc.subject||Magnetic resonance imaging, computed tomography, rectal cancer, liver metastasis||sv
|dc.title||Magnetic Resonance Imaging or Contrast-Enhanced Computed Tomography of the Liver as Standard Workup Before Treatment for Rectal Cancer||sv
|dc.contributor.department||University of Gothenburg / Institute of Medicine||eng
|dc.contributor.department||Göteborgs universitet / Institutionen för medicin||swe