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Abstract #1528

Hypoenhancing liver lesion on both portovenous and delayed phase gadobutrol and gadofosveset-enhanced MRI as a sign of malignancy in the diagnosis of colorectal liver metastases (CRLM)

Helen Cheung 1 , Paul Karanicolas 2 , Chirag Patel 1 , Natalie Coburn 2 , Masoom A Haider 1 , Calvin Law 2 , and Laurent Milot 1

1 Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, 2 Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

Accurate diagnosis of colorectal liver metastases (CRLM) is a common and important clinical problem. Classically, CRLM appear hypoenhancing on portovenous and delayed phases with dynamic contrast enhanced MRI using extracellular contrast agents (eg. gadobutrol). These CRLM tend to be easy to diagnose because benign lesions rarely demonstrate this sign. However, some CRLM will not follow this pattern and can be difficult to diagnose. We hypothesize that more lesions will demonstrate this sign with intravascular contrast agents (eg. gadofosveset) leading to improved diagnosis. With gadofosveset, 26% more lesions demonstrated this sign than with gadobutrol, resulting in improved sensitivity (65% to 90%).

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