In the European CAMINO study reported in The Lancet Oncology, Görgec et al identified the likelihood of change in treatment plans with the addition of contrast-enhanced magnetic resonance imaging (MRI) in patients scheduled for local therapy for colorectal liver metastases on the basis of contrast-enhanced computed tomography (CT).
Study Details
The study included 298 patients enrolled between December 2019 and July 2021 from 14 liver surgery centers in the Netherlands, Belgium, Norway, and Italy. All patients received contrast-enhanced CT and liver contrast-enhanced MRI, including diffusion-weighted imaging and gadoxetic acid as a contrast agent, before undergoing local therapy. The primary outcome measure was to determine the effect of MRI on CT-based treatment planning in the intention-to treat population.
Key Findings
MRI findings changed the local treatment plan based on CT in 92 of 298 patients (31%, 95% confidence interval [CI] = 26%–36%). Changes associated with MRI findings included changes in the need for more extensive local therapy in 40 patients (13%) and the need for less extensive local therapy in 11 patients (4%); in 34 patients (11%), the indication for curative-intent local therapy was revoked, including 26 patients (9%) with disease that was considered too extensive and 8 (3%) with benign lesions on MRI.
The investigators concluded: “Liver contrast-enhanced MRI should be considered in all patients scheduled for local treatment for colorectal liver metastases on the basis of contrast-enhanced CT imaging.”
Jaap Stoker, MD, of the Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, is the corresponding author of The Lancet Oncology article.
Disclosure: The study was supported by the Dutch Cancer Society and Bayer AG-Pharmaceuticals. For full disclosures of the study authors, visit thelancet.com.
