Implementing Integrated Quality Assurance (SURCARE) for EORTC-JCOG 1527 / ESSO 02: Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) Assessment of Liver Metastasis to Improve Surgical Planning (DREAM)

Abstract

For patients with initially unresectable colorectal liver metastases (CRLM) with good clinical response to chemotherapy, the presence of disappearing liver metastases (DLMs) diagnosed by CT is a major independent prognostic factor. However, correlation between radiological and pathological complete response has not been fully investigated using the latest imaging and pathology techniques. DW-MRI and contrast enhanced (CE)-MRI are recommended to detect and characterise CRLM. Our main aim is to demonstrate the added value of DW-MRI, CE-MRI and CT scan to provide precise assessment of the viability of DLMs. In addition, we aim to improve prognostication and treatment strategies for CRLM patients using parenchymal sparing surgery (PSS). No large scale study has been conducted to date to determine the predictive value of DW-MRI combined with CE-MRI in confirming sites of DLMs and assessing their true status. This is the first collaborative study between EORTC, ESSO and JCOG with an integrated quality assurance (QA) program for imaging, surgery and pathology. Together, we also developed an infrastructure for surgical QA in clinical trials (SURCARE) to advance the surgical oncology research agenda in Europe and Asia.