Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer

Abstract Some liver nodules remain indeterminate despite hepatocyte-specific contrast MRI in patients with colorectal liver metastasis (CRLM). Our objective was to study the natural course and evaluate possible treatment strategies for indeterminate nodules. We retrospectively evaluated patients in...

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Autores principales:	Mizelle D’Silva, Jai Young Cho, Ho-Seong Han, Taupyk Yerlan, Yoo-Seok Yoon, Hae Won Lee, Jun Suh Lee, Boram Lee, Moonhwan Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/60a2879894844cc2b49d0424e4ca0749
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spelling	oai:doaj.org-article:60a2879894844cc2b49d0424e4ca07492021-12-02T14:33:57ZManagement of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer10.1038/s41598-021-93339-w2045-2322https://doaj.org/article/60a2879894844cc2b49d0424e4ca07492021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93339-whttps://doaj.org/toc/2045-2322Abstract Some liver nodules remain indeterminate despite hepatocyte-specific contrast MRI in patients with colorectal liver metastasis (CRLM). Our objective was to study the natural course and evaluate possible treatment strategies for indeterminate nodules. We retrospectively evaluated patients in whom MRI revealed ‘indeterminate’ or ‘equivocal’ nodules between January 2008 and October 2018. Patients were followed up until October 2019 or until death (median, 18 months; (1–130 months)). The incidence of patients with indeterminate nodules on MRI was 15.4% (60 of 389). The sensitivity and specificity of intraoperative ultrasound for detecting indeterminate nodules were 73.68% and 93.75%, respectively, with a positive predictive value of 96.6%. Over half of the patients followed up had benign nodules (58.8%). By comparing characteristics of patients with benign or malignant nodules in the follow up group, the ratio of positive lymph nodes to total number of lymph nodes resected (pLNR) was significantly greater in patients with malignant nodules (P = 0.006). Intraoperative ultrasound could be considered as an adjunct to MRI in patients with indeterminate nodules owing to its high positive predictive value. The pLNR could be used to help select which patients can undergo conservative therapy, at least in metachronous CRLM.Mizelle D’SilvaJai Young ChoHo-Seong HanTaupyk YerlanYoo-Seok YoonHae Won LeeJun Suh LeeBoram LeeMoonhwan KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mizelle D’Silva Jai Young Cho Ho-Seong Han Taupyk Yerlan Yoo-Seok Yoon Hae Won Lee Jun Suh Lee Boram Lee Moonhwan Kim Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
description	Abstract Some liver nodules remain indeterminate despite hepatocyte-specific contrast MRI in patients with colorectal liver metastasis (CRLM). Our objective was to study the natural course and evaluate possible treatment strategies for indeterminate nodules. We retrospectively evaluated patients in whom MRI revealed ‘indeterminate’ or ‘equivocal’ nodules between January 2008 and October 2018. Patients were followed up until October 2019 or until death (median, 18 months; (1–130 months)). The incidence of patients with indeterminate nodules on MRI was 15.4% (60 of 389). The sensitivity and specificity of intraoperative ultrasound for detecting indeterminate nodules were 73.68% and 93.75%, respectively, with a positive predictive value of 96.6%. Over half of the patients followed up had benign nodules (58.8%). By comparing characteristics of patients with benign or malignant nodules in the follow up group, the ratio of positive lymph nodes to total number of lymph nodes resected (pLNR) was significantly greater in patients with malignant nodules (P = 0.006). Intraoperative ultrasound could be considered as an adjunct to MRI in patients with indeterminate nodules owing to its high positive predictive value. The pLNR could be used to help select which patients can undergo conservative therapy, at least in metachronous CRLM.
format	article
author	Mizelle D’Silva Jai Young Cho Ho-Seong Han Taupyk Yerlan Yoo-Seok Yoon Hae Won Lee Jun Suh Lee Boram Lee Moonhwan Kim
author_facet	Mizelle D’Silva Jai Young Cho Ho-Seong Han Taupyk Yerlan Yoo-Seok Yoon Hae Won Lee Jun Suh Lee Boram Lee Moonhwan Kim
author_sort	Mizelle D’Silva
title	Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
title_short	Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
title_full	Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
title_fullStr	Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
title_full_unstemmed	Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
title_sort	management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/60a2879894844cc2b49d0424e4ca0749
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Management of indeterminate hepatic nodules and evaluation of factors predicting their malignant potential in patients with colorectal cancer

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