The value of magnetic resonance imaging in differentiating the histopathological growth patterns of Liver metastases of colorectal cancer

Abstract

Abstract: Objective To evaluate the value of magnetic resonance imaging (MRI) in differentiating the type of histopathological growth patterns (HGP) of patients with liver metastases of colorectal cancers (CRLM). Methods From January 2010 to January 2022, the clinical and pathological data of 42 patients with CRLM that were confirmed by pathological observation on surgical resection tissues were collected. The average age was (59.4 ± 8.5) years old, including 25 males and 17 females. According to the international expert consensus standard, when there is an advantage (>50%) in promoting the proliferation, replacement or pushing of fibrous tissue in HGPs of CRLM patients, it is classified as promoting the proliferation of desmoplastic HGP (dHGP), replacement HGP (rHGP) or pushing HGP (pHGP), respectively. When the type of dHGP, rHGP or pHGP is less than 50%, it is defined as mixed HGP. The clinical data of CRLM patients with different HGP types were compared, followed by ROC curve analysis and the calculation of diagnostic AUC value. Results Among 42 CRLM patients, dHGP, rHGP and pHGP were 20 cases, 11 cases and 11 cases, respectively, and there was no mixed HGP case. When comparing the general data of rHGP and non-rHGP (dHGP, pHGP), there was no significant difference in the location, pathological type, T stage and N stage of liver metastases (P>0.05). Comparing the MRI findings of CRLM patients with rHGP and non-rHGP, the tumor diameters before and after enhancement was (0.30 ± 0.12) cm and (0.08 ± 0.03) cm, respectively, which had statistically significant difference (P<0.05). There were 11 cases (100%) and 14 cases (45.2%) of rim enhancement in the rHGP and non-rHGP patients, respectively, with statistically significant difference (P<0.05). The AUC value for the combination of the tumor diameter difference before and after enhancement with rim enhancement for distinguishing rHGP from non-rHGP was 0.852 (95% CI: 0.718 ~ 0.986). Conclusion Compared with dHGP and pHGP, rHGP CRLM is more prone to MRI rim enhancement, and the tumor diameter is also significantly increased after enhancement. MRI features such as the difference of tumor diameter before and after enhancement can effectively distinguish rHGP and non-rHGP CRLM patients.

Key words: Colorectal liver metastases, Histopathological growth patterns, Rim enhancement

GU Yun-rui, GU Ji-yong. The value of magnetic resonance imaging in differentiating the histopathological growth patterns of Liver metastases of colorectal cancer[J]. Chinese Hepatolgy, 2022, 27(9): 990-993.

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