Evaluation of peripheral enhancement on contrast-enhanced computed tomography and corresponding pathological findings in colorectal liver metastases after preoperative chemotherapy

Abstract

PurposeTo correlate peripheral enhancement on contrast-enhanced computed tomography (CE-CT) in patients with post-chemotherapy colorectal liver metastases (CRLM) with the corresponding pathological findings.Material and methodsForty-four patients with CRLM who underwent hepatic resection after preoperative chemotherapy between 2008 and 2013 were included. Two radiologists blinded to the histopathology findings performed a consensus categorization of the marginal contrast effects of CRLM on CE-CT as follows: Group 1, smooth margin without enhancement; Group 2, smooth margin with an enhanced rim; and Group 3, fuzzy margin with/without an enhanced rim. The Kruskal-Wallis test was used to compare the imaging findings with the histological findings.ResultsThe percentage of infarct-like necrosis was significantly higher in those with CRLM with smooth margins than in those with CRLM with fuzzy margins (<i>p</i> < 0.001, <i>r</i> = 0.62). The percentage of viable cells was lowest in CRLM with smooth margins without enhancement (<i>p</i> < 0.001, <i>r</i> = 0.60).ConclusionsOur findings suggest that the type of necrosis is related to the nature of the margins, and the presence of residual cells is related to peripheral enhancement.