Preoperative imaging for colorectal liver metastases: a nationwide population-based study

A K E Elfrink; M Pool; the Dutch Hepato-Biliary Audit Group; L R van der Werf; E Marra; M C Burgmans; M R Meijerink; M den Dulk; P B van den Boezem; W W Te Riele; G A Patijn; M W J M Wouters; W K G Leclercq; M S L Liem; P D Gobardhan; C I Buis; K F D Kuhlmann; C Verhoef; M G Besselink; D J Grünhagen; J M Klaase; N F M Kok

doi:10.1002/bjs5.50291

Preoperative imaging for colorectal liver metastases: a nationwide population-based study

A K E Elfrink^*, M Pool, the Dutch Hepato-Biliary Audit Group, L R van der Werf, E Marra, M C Burgmans, M R Meijerink, M den Dulk, P B van den Boezem, W W Te Riele, G A Patijn, M W J M Wouters, W K G Leclercq, M S L Liem, P D Gobardhan, C I Buis, K F D Kuhlmann, C Verhoef, M G Besselink, D J GrünhagenJ M Klaase, N F M Kok

^*Corresponding author for this work

Surgery

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Abstract

BACKGROUND: In patients with colorectal liver metastases (CRLM) preoperative imaging may include contrast-enhanced (ce) MRI and [18 F]fluorodeoxyglucose (18 F-FDG) PET-CT. This study assessed trends and variation between hospitals and oncological networks in the use of preoperative imaging in the Netherlands.

METHODS: Data for all patients who underwent liver resection for CRLM in the Netherlands between 2014 and 2018 were retrieved from a nationwide auditing database. Multivariable logistic regression analysis was used to assess use of ceMRI, 18 F-FDG PET-CT and combined ceMRI and 18 F-FDG PET-CT, and trends in preoperative imaging and hospital and oncological network variation.

RESULTS: A total of 4510 patients were included, of whom 1562 had ceMRI, 872 had 18 F-FDG PET-CT, and 1293 had combined ceMRI and 18 F-FDG PET-CT. Use of ceMRI increased over time (from 9·6 to 26·2 per cent; P < 0·001), use of 18 F-FDG PET-CT decreased (from 28·6 to 6·0 per cent; P < 0·001), and use of both ceMRI and 18 F-FDG PET-CT 16·9 per cent) remained stable. Unadjusted variation in the use of ceMRI, 18 F-FDG PET-CT, and combined ceMRI and 18 F-FDG PET-CT ranged from 5·6 to 100 per cent between hospitals. After case-mix correction, hospital and oncological network variation was found for all imaging modalities.

DISCUSSION: Significant variation exists concerning the use of preoperative imaging for CRLM between hospitals and oncological networks in the Netherlands. The use of MRI is increasing, whereas that of 18 F-FDG PET-CT is decreasing.

Original language	English
Pages (from-to)	605-621
Number of pages	17
Journal	BJS open
Volume	4
Issue number	4
DOIs	https://doi.org/10.1002/bjs5.50291
Publication status	Published - Aug 2020

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Elfrink, A. K. E., Pool, M., the Dutch Hepato-Biliary Audit Group, van der Werf, L. R., Marra, E., Burgmans, M. C., Meijerink, M. R., den Dulk, M., van den Boezem, P. B., Te Riele, W. W., Patijn, G. A., Wouters, M. W. J. M., Leclercq, W. K. G., Liem, M. S. L., Gobardhan, P. D., Buis, C. I., Kuhlmann, K. F. D., Verhoef, C., Besselink, M. G., ... Kok, N. F. M. (2020). Preoperative imaging for colorectal liver metastases: a nationwide population-based study. BJS open, 4(4), 605-621. https://doi.org/10.1002/bjs5.50291

@article{a6f06c5b757043d1b5833e7e49956e7e,

title = "Preoperative imaging for colorectal liver metastases: a nationwide population-based study",

abstract = "BACKGROUND: In patients with colorectal liver metastases (CRLM) preoperative imaging may include contrast-enhanced (ce) MRI and [18 F]fluorodeoxyglucose (18 F-FDG) PET-CT. This study assessed trends and variation between hospitals and oncological networks in the use of preoperative imaging in the Netherlands.METHODS: Data for all patients who underwent liver resection for CRLM in the Netherlands between 2014 and 2018 were retrieved from a nationwide auditing database. Multivariable logistic regression analysis was used to assess use of ceMRI, 18 F-FDG PET-CT and combined ceMRI and 18 F-FDG PET-CT, and trends in preoperative imaging and hospital and oncological network variation.RESULTS: A total of 4510 patients were included, of whom 1562 had ceMRI, 872 had 18 F-FDG PET-CT, and 1293 had combined ceMRI and 18 F-FDG PET-CT. Use of ceMRI increased over time (from 9·6 to 26·2 per cent; P < 0·001), use of 18 F-FDG PET-CT decreased (from 28·6 to 6·0 per cent; P < 0·001), and use of both ceMRI and 18 F-FDG PET-CT 16·9 per cent) remained stable. Unadjusted variation in the use of ceMRI, 18 F-FDG PET-CT, and combined ceMRI and 18 F-FDG PET-CT ranged from 5·6 to 100 per cent between hospitals. After case-mix correction, hospital and oncological network variation was found for all imaging modalities.DISCUSSION: Significant variation exists concerning the use of preoperative imaging for CRLM between hospitals and oncological networks in the Netherlands. The use of MRI is increasing, whereas that of 18 F-FDG PET-CT is decreasing.",

author = "Elfrink, {A K E} and M Pool and {the Dutch Hepato-Biliary Audit Group} and {van der Werf}, {L R} and E Marra and Burgmans, {M C} and Meijerink, {M R} and {den Dulk}, M and {van den Boezem}, {P B} and {Te Riele}, {W W} and Patijn, {G A} and Wouters, {M W J M} and Leclercq, {W K G} and Liem, {M S L} and Gobardhan, {P D} and Buis, {C I} and Kuhlmann, {K F D} and C Verhoef and Besselink, {M G} and Gr{\"u}nhagen, {D J} and Klaase, {J M} and Kok, {N F M}",

note = "{\textcopyright} 2020 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of British Journal of Surgery Society.",

year = "2020",

month = aug,

doi = "10.1002/bjs5.50291",

language = "English",

volume = "4",

pages = "605--621",

journal = "BJS open",

issn = "2474-9842",

publisher = "Oxford University Press",

number = "4",

}

Elfrink, AKE, Pool, M, the Dutch Hepato-Biliary Audit Group, van der Werf, LR, Marra, E, Burgmans, MC, Meijerink, MR, den Dulk, M, van den Boezem, PB, Te Riele, WW, Patijn, GA, Wouters, MWJM, Leclercq, WKG, Liem, MSL, Gobardhan, PD, Buis, CI, Kuhlmann, KFD, Verhoef, C, Besselink, MG, Grünhagen, DJ, Klaase, JM & Kok, NFM 2020, 'Preoperative imaging for colorectal liver metastases: a nationwide population-based study', BJS open, vol. 4, no. 4, pp. 605-621. https://doi.org/10.1002/bjs5.50291

TY - JOUR

T1 - Preoperative imaging for colorectal liver metastases

T2 - a nationwide population-based study

AU - Elfrink, A K E

AU - Pool, M

AU - the Dutch Hepato-Biliary Audit Group

AU - van der Werf, L R

AU - Marra, E

AU - Burgmans, M C

AU - Meijerink, M R

AU - den Dulk, M

AU - van den Boezem, P B

AU - Te Riele, W W

AU - Patijn, G A

AU - Wouters, M W J M

AU - Leclercq, W K G

AU - Liem, M S L

AU - Gobardhan, P D

AU - Buis, C I

AU - Kuhlmann, K F D

AU - Verhoef, C

AU - Besselink, M G

AU - Grünhagen, D J

AU - Klaase, J M

AU - Kok, N F M

PY - 2020/8

Y1 - 2020/8

N2 - BACKGROUND: In patients with colorectal liver metastases (CRLM) preoperative imaging may include contrast-enhanced (ce) MRI and [18 F]fluorodeoxyglucose (18 F-FDG) PET-CT. This study assessed trends and variation between hospitals and oncological networks in the use of preoperative imaging in the Netherlands.METHODS: Data for all patients who underwent liver resection for CRLM in the Netherlands between 2014 and 2018 were retrieved from a nationwide auditing database. Multivariable logistic regression analysis was used to assess use of ceMRI, 18 F-FDG PET-CT and combined ceMRI and 18 F-FDG PET-CT, and trends in preoperative imaging and hospital and oncological network variation.RESULTS: A total of 4510 patients were included, of whom 1562 had ceMRI, 872 had 18 F-FDG PET-CT, and 1293 had combined ceMRI and 18 F-FDG PET-CT. Use of ceMRI increased over time (from 9·6 to 26·2 per cent; P < 0·001), use of 18 F-FDG PET-CT decreased (from 28·6 to 6·0 per cent; P < 0·001), and use of both ceMRI and 18 F-FDG PET-CT 16·9 per cent) remained stable. Unadjusted variation in the use of ceMRI, 18 F-FDG PET-CT, and combined ceMRI and 18 F-FDG PET-CT ranged from 5·6 to 100 per cent between hospitals. After case-mix correction, hospital and oncological network variation was found for all imaging modalities.DISCUSSION: Significant variation exists concerning the use of preoperative imaging for CRLM between hospitals and oncological networks in the Netherlands. The use of MRI is increasing, whereas that of 18 F-FDG PET-CT is decreasing.

AB - BACKGROUND: In patients with colorectal liver metastases (CRLM) preoperative imaging may include contrast-enhanced (ce) MRI and [18 F]fluorodeoxyglucose (18 F-FDG) PET-CT. This study assessed trends and variation between hospitals and oncological networks in the use of preoperative imaging in the Netherlands.METHODS: Data for all patients who underwent liver resection for CRLM in the Netherlands between 2014 and 2018 were retrieved from a nationwide auditing database. Multivariable logistic regression analysis was used to assess use of ceMRI, 18 F-FDG PET-CT and combined ceMRI and 18 F-FDG PET-CT, and trends in preoperative imaging and hospital and oncological network variation.RESULTS: A total of 4510 patients were included, of whom 1562 had ceMRI, 872 had 18 F-FDG PET-CT, and 1293 had combined ceMRI and 18 F-FDG PET-CT. Use of ceMRI increased over time (from 9·6 to 26·2 per cent; P < 0·001), use of 18 F-FDG PET-CT decreased (from 28·6 to 6·0 per cent; P < 0·001), and use of both ceMRI and 18 F-FDG PET-CT 16·9 per cent) remained stable. Unadjusted variation in the use of ceMRI, 18 F-FDG PET-CT, and combined ceMRI and 18 F-FDG PET-CT ranged from 5·6 to 100 per cent between hospitals. After case-mix correction, hospital and oncological network variation was found for all imaging modalities.DISCUSSION: Significant variation exists concerning the use of preoperative imaging for CRLM between hospitals and oncological networks in the Netherlands. The use of MRI is increasing, whereas that of 18 F-FDG PET-CT is decreasing.

U2 - 10.1002/bjs5.50291

DO - 10.1002/bjs5.50291

M3 - Article

C2 - 32374497

SN - 2474-9842

VL - 4

SP - 605

EP - 621

JO - BJS open

JF - BJS open

IS - 4

ER -

Preoperative imaging for colorectal liver metastases: a nationwide population-based study

Abstract

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