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

  • A K E Elfrink*
  • , M Pool
  • , Dutch Hepato Biliary Audit (DHBA)
  • , 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
*Corresponding author for this work
  • Amsterdam UMC
  • Dutch Institute for Clinical Auditing (DICA)
  • Leiden University Medical Centre
  • Radboud University Medical Center
  • University Medical Centre Utrecht
  • Isala Clinics
  • Maxima Medical Centre
  • Amphia Hospital
  • The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital
  • University Medical Centre Groningen
  • Vrije Universiteit Amsterdam
  • Maastricht University Medical Centre
  • Medisch Spectrum Twente
  • Netherlands Cancer Institute

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)
37 Downloads (Pure)

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 languageEnglish
Pages (from-to)605-621
Number of pages17
JournalBJS open
Volume4
Issue number4
DOIs
Publication statusPublished - Aug 2020

Bibliographical note

© 2020 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of British Journal of Surgery Society.

Research programs

  • EMC OR-01

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