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Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer

Some liver nodules remain indeterminate despite hepatocyte-specific contrast MRI in patients with colorectal liver metastasis (CRLM). Our objective was to study the natural course and evaluate possible treatment strategies for indeterminate nodules. We retrospectively evaluated patients in whom MRI...

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Autores principales: D’Silva, Mizelle, Cho, Jai Young, Han, Ho-Seong, Yerlan, Taupyk, Yoon, Yoo-Seok, Lee, Hae Won, Lee, Jun Suh, Lee, Boram, Kim, Moonhwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8253834/
https://www.ncbi.nlm.nih.gov/pubmed/34215816
http://dx.doi.org/10.1038/s41598-021-93339-w
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author D’Silva, Mizelle
Cho, Jai Young
Han, Ho-Seong
Yerlan, Taupyk
Yoon, Yoo-Seok
Lee, Hae Won
Lee, Jun Suh
Lee, Boram
Kim, Moonhwan
author_facet D’Silva, Mizelle
Cho, Jai Young
Han, Ho-Seong
Yerlan, Taupyk
Yoon, Yoo-Seok
Lee, Hae Won
Lee, Jun Suh
Lee, Boram
Kim, Moonhwan
author_sort D’Silva, Mizelle
collection PubMed
description Some liver nodules remain indeterminate despite hepatocyte-specific contrast MRI in patients with colorectal liver metastasis (CRLM). Our objective was to study the natural course and evaluate possible treatment strategies for indeterminate nodules. We retrospectively evaluated patients in whom MRI revealed ‘indeterminate’ or ‘equivocal’ nodules between January 2008 and October 2018. Patients were followed up until October 2019 or until death (median, 18 months; (1–130 months)). The incidence of patients with indeterminate nodules on MRI was 15.4% (60 of 389). The sensitivity and specificity of intraoperative ultrasound for detecting indeterminate nodules were 73.68% and 93.75%, respectively, with a positive predictive value of 96.6%. Over half of the patients followed up had benign nodules (58.8%). By comparing characteristics of patients with benign or malignant nodules in the follow up group, the ratio of positive lymph nodes to total number of lymph nodes resected (pLNR) was significantly greater in patients with malignant nodules (P = 0.006). Intraoperative ultrasound could be considered as an adjunct to MRI in patients with indeterminate nodules owing to its high positive predictive value. The pLNR could be used to help select which patients can undergo conservative therapy, at least in metachronous CRLM.
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spelling pubmed-82538342021-07-06 Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer D’Silva, Mizelle Cho, Jai Young Han, Ho-Seong Yerlan, Taupyk Yoon, Yoo-Seok Lee, Hae Won Lee, Jun Suh Lee, Boram Kim, Moonhwan Sci Rep Article Some liver nodules remain indeterminate despite hepatocyte-specific contrast MRI in patients with colorectal liver metastasis (CRLM). Our objective was to study the natural course and evaluate possible treatment strategies for indeterminate nodules. We retrospectively evaluated patients in whom MRI revealed ‘indeterminate’ or ‘equivocal’ nodules between January 2008 and October 2018. Patients were followed up until October 2019 or until death (median, 18 months; (1–130 months)). The incidence of patients with indeterminate nodules on MRI was 15.4% (60 of 389). The sensitivity and specificity of intraoperative ultrasound for detecting indeterminate nodules were 73.68% and 93.75%, respectively, with a positive predictive value of 96.6%. Over half of the patients followed up had benign nodules (58.8%). By comparing characteristics of patients with benign or malignant nodules in the follow up group, the ratio of positive lymph nodes to total number of lymph nodes resected (pLNR) was significantly greater in patients with malignant nodules (P = 0.006). Intraoperative ultrasound could be considered as an adjunct to MRI in patients with indeterminate nodules owing to its high positive predictive value. The pLNR could be used to help select which patients can undergo conservative therapy, at least in metachronous CRLM. Nature Publishing Group UK 2021-07-02 /pmc/articles/PMC8253834/ /pubmed/34215816 http://dx.doi.org/10.1038/s41598-021-93339-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
D’Silva, Mizelle
Cho, Jai Young
Han, Ho-Seong
Yerlan, Taupyk
Yoon, Yoo-Seok
Lee, Hae Won
Lee, Jun Suh
Lee, Boram
Kim, Moonhwan
Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
title Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
title_full Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
title_fullStr Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
title_full_unstemmed Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
title_short Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
title_sort management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8253834/
https://www.ncbi.nlm.nih.gov/pubmed/34215816
http://dx.doi.org/10.1038/s41598-021-93339-w
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