Dynamic Contrast-Enhanced MRI for Assessing Histopathological Growth Patterns and Prognosis in Colorectal Liver...

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• The desmoplastic histopathological growth pattern (dHGP) in colorectal liver metastases (CRLM) correlates with improved survival and response to anti-angiogenic chemotherapy.
• Accurate preoperative identification of dHGP using MRI remains a clinical challenge.

Purpose of the Study:

• To develop a predictive model using dynamic contrast-enhanced MRI (DCE-MRI) to assess the probability of dHGP.
• To aid in selecting patients for anti-angiogenic neoadjuvant chemotherapy and for prognostic evaluation.

Main Methods:

• Retrospective, dual-center study involving 286 patients with pathologically confirmed CRLM.
• Analysis of DCE-MRI features, specifically peritumoral rim enhancement across different phases (arterial, portal venous, delayed).
• Statistical analysis included logistic regression, ROC curve analysis (AUC), and survival analysis (Kaplan-Meier, log-rank test).

Main Results:

• Peritumoral rim enhancement on DCE-MRI was significantly associated with dHGP across all assessed phases (ORs ranging from 3.55 to 7.46).
• A DCE-MRI-based model demonstrated high diagnostic performance (AUCs of 0.86 and 0.82 for development and validation cohorts).
• Peritumoral rim enhancement independently predicted longer disease-free survival (DFS) and overall survival (OS) in all patients and those receiving bevacizumab-based chemotherapy.

Conclusions:

• Peritumoral rim enhancement on DCE-MRI is a reliable imaging biomarker for dHGP in CRLM.
• This finding suggests favorable prognosis and potential for identifying candidates for anti-angiogenic therapy.