Risk factor assessment to predict the likelihood of a diagnosis of metastasis for indeterminate hepatic lesions found at computed tomography in patients with rectal cancer.

AIM: To assess the significant factors on rectal magnetic resonance imaging (MRI) to predict the likelihood of a diagnosis of metastasis for indeterminate hepatic lesions found at computed tomography (CT) in patients with rectal cancer.

MATERIALS AND METHODS: A total of 207 patients with rectal cancer who underwent preoperative contrast-enhanced abdominopelvic CT, and rectal and liver MRI were included. Univariate analysis and multivariate logistic regression were used to evaluate the determining factors for the significance of indeterminate hepatic lesions on CT in patients with rectal cancer.

RESULTS: Hepatic metastases were diagnosed in 29 (20.9%) of 139 patients who had indeterminate hepatic lesions on preoperative CT obtained for rectal cancer. On univariate analysis, carcinoembryonic antigen level, N stage, mesorectal fascia (MRF) invasion, diameter of superior haemorrhoidal vein, and mesorectal vascular lesion (MVL) grade on rectal MRI (p<0.05) were associated with the possibility of metastasis for indeterminate hepatic lesions on CT. On multivariate analysis, MVL grade and MRF invasion on rectal MRI were independent factors associated with the possibility of metastasis for indeterminate hepatic lesions on CT (p<0.0005 and p=0.0066, respectively).

CONCLUSION: MVL grade and MRF invasion on rectal MRI are independent factors for estimating hepatic metastasis among indeterminate hepatic lesions on CT in patients with rectal cancer.