Clinical Added Value of MRI to CT in Patients Scheduled for Local Therapy of Colorectal Liver Metastases (CAMINO): An International Multicenter Prospective Diagnostic Accuracy Study

Abstract

Background: Computed Tomography(CT) is the standard imaging method in the diagnostic workup of patients with colorectal liver metastases(CRLM). Compared to CT, magnetic resonance imaging (MRI) is superior in detection and characterization of CRLM but its effect on patient management is unknown. The aim of this study is to evaluate whether MRI has sufficient clinical added value to be routinely added to CT in staging CRLM. Methods: An international multicenter prospective incremental diagnostic accuracy study in consecutive patients with primary or recurrent CRLM scheduled for curative liver resection or thermal ablation based on CT, recruited in centers across the Netherlands, Belgium, Norway, and Italy. All patients had CT and diffusion-weighted and gadoxetic-acid enhanced MRI prior to local therapy. Primary outcome is the proportion of clinically significant CRLM (CS-CRLM) detected by MRI, but not visible on CT, leading to a change in local treatment plan. The minimum incremental diagnostic accuracy of MRI for CS-CRLM was set at 10% of patients. Results: Patient recruitment was completed in July 2021 with 299 patients included from 15 centers. Data collection is currently ongoing and will be completed in January 2022 with the 6 months follow-up of the last patient included. Results will be available prior to IHBPA 2022. Conclusion: The CAMINO study will clarify the clinical added value of MRI to CT in patients with CRLM scheduled for local therapy. This study will provide evidence required for the implementation of MRI in the routine work-up of patients with primary and recurrent CRLM scheduled for local therapy.