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The following is a summary of “Diagnostic performance of contrast-enhanced CT combined with contrast-enhanced MRI for colorectal liver metastases: a case-control study,” published in the March 2025 issue of the BMC Gastroenterology by Zhang and Bai.

Colorectal liver metastases (CRLM) represent a critical factor influencing prognosis in patients with colorectal cancer (CRC), necessitating early and precise detection to optimize therapeutic planning and improve survival rates. This study aims to assess the diagnostic efficacy of contrast-enhanced computed tomography (CT) and contrast-enhanced magnetic resonance imaging (MRI) in detecting CRLM. A case-control design was employed, including 85 patients with histologically confirmed CRLM and 85 matched controls without liver metastases. All participants underwent both contrast-enhanced CT and 3-Tesla (3-T) MRI to ensure high-resolution imaging and detailed lesion characterization. The diagnostic performance of these modalities was evaluated based on sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and radiologists’ diagnostic confidence. 

Additionally, an inter-observer agreement was analyzed using kappa statistics to determine consistency between two independent radiologists reviewing the scans. The findings indicate that while MRI alone exhibited high sensitivity (90.6%) and specificity (95.3%), the combination of contrast-enhanced CT and MRI further enhanced diagnostic accuracy, achieving a sensitivity of 96.5% and specificity of 98.3%. The integration of both modalities also improved PPV and NPV, reinforcing the reliability of the combined approach. Furthermore, radiologists’ diagnostic confidence increased significantly when using both imaging techniques, with 78.8% of cases classified at a ‘very high’ confidence level compared to 64.7% with MRI alone. Inter-observer agreement reached an ‘almost perfect’ level with the combined approach, highlighting its reproducibility and robustness in clinical practice. 

These results underscore the substantial advantage of integrating contrast-enhanced CT with MRI in the preoperative assessment of patients with CRC, facilitating more accurate lesion detection and enhancing treatment decision-making. This study supports the adoption of a multimodal imaging strategy for CRLM evaluation, ultimately contributing to improved clinical outcomes and individualized patient management.

Source:bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-03785-3