Title: Diagnostic performance of contrast-enhanced CT combined with contrast-enhanced MRI
for colorectal liver metastases: A case-control study
Version: 1 Date: 06 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-While retrospective studies are common for this type of research, they are prone to selection bias
and confounding factors that can influence the results. The authors mention that convenience
sampling was used, which may not be representative of the broader population. A prospective
study design could minimize such biases and provide stronger evidence.
-Although the use of matching methods helps control for some confounders, the reliance on
convenience sampling limits the generalizability of the results. A more randomized sampling
approach would increase the external validity of the findings.
-The study focuses primarily on diagnostic accuracy without assessing the impact of the imaging
modalities on clinical outcomes such as treatment decisions, patient survival, or recurrence
rates. Long-term follow-up data would provide valuable insights into how multimodal imaging
influences therapeutic planning and patient prognosis.
-The study focuses on diagnostic accuracy but does not address the potential cost-effectiveness
of combining CT and MRI. Given that combining these imaging modalities could increase
healthcare costs, it would be useful to discuss whether the improvement in diagnostic accuracy
justifies the added expense, especially in resource-limited settings.
-While the discussion highlights statistical significance in diagnostic accuracy, it would be
beneficial to discuss the clinical significance of these findings more explicitly. For instance,
how much earlier could MRI potentially detect metastases compared to CT? Are there specific
subgroups of patients who would benefit most from MRI, such as those with small lesions or
early-stage metastases? Providing more context about how the differences in sensitivity and
specificity might translate to real-world clinical practice could make the results more tangible
for readers.
-The combined use of CT and MRI is mentioned as enhancing diagnostic accuracy, particularly
in detecting small lesions, but the discussion could elaborate further on why combining
these modalities leads to higher diagnostic confidence. It would also be helpful to explore
potential drawbacks or challenges in clinical practice when using combined imaging (e.g., added
costs, increased time for interpretation, or patient burden) and how these could be addressed.
Discussing the specific benefits of combining both modalities could strengthen the argument
for adopting this approach.
Title: Diagnostic performance of contrast-enhanced CT combined with contrast-enhanced MRI
for colorectal liver metastases: A case-control study
Version: 1 Date: 06 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-While retrospective studies are common for this type of research, they are prone to selection bias
and confounding factors that can influence the results. The authors mention that convenience
sampling was used, which may not be representative of the broader population. A prospective
study design could minimize such biases and provide stronger evidence.
-Although the use of matching methods helps control for some confounders, the reliance on
convenience sampling limits the generalizability of the results. A more randomized sampling
approach would increase the external validity of the findings.
-The study focuses primarily on diagnostic accuracy without assessing the impact of the imaging
modalities on clinical outcomes such as treatment decisions, patient survival, or recurrence
rates. Long-term follow-up data would provide valuable insights into how multimodal imaging
influences therapeutic planning and patient prognosis.
-The study focuses on diagnostic accuracy but does not address the potential cost-effectiveness
of combining CT and MRI. Given that combining these imaging modalities could increase
healthcare costs, it would be useful to discuss whether the improvement in diagnostic accuracy
justifies the added expense, especially in resource-limited settings.
-While the discussion highlights statistical significance in diagnostic accuracy, it would be
beneficial to discuss the clinical significance of these findings more explicitly. For instance,
how much earlier could MRI potentially detect metastases compared to CT? Are there specific
subgroups of patients who would benefit most from MRI, such as those with small lesions or
early-stage metastases? Providing more context about how the differences in sensitivity and
specificity might translate to real-world clinical practice could make the results more tangible
for readers.
-The combined use of CT and MRI is mentioned as enhancing diagnostic accuracy, particularly
in detecting small lesions, but the discussion could elaborate further on why combining
these modalities leads to higher diagnostic confidence. It would also be helpful to explore
potential drawbacks or challenges in clinical practice when using combined imaging (e.g., added
costs, increased time for interpretation, or patient burden) and how these could be addressed.
Discussing the specific benefits of combining both modalities could strengthen the argument
for adopting this approach.
Please review this paper.
user
Title: Diagnostic performance of contrast-enhanced CT combined with contrast-enhanced MRI
for colorectal liver metastases: A case-control study
Version: 1 Date: 06 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-While retrospective studies are common for this type of research, they are prone to selection bias
and confounding factors that can influence the results. The authors mention that convenience
sampling was used, which may not be representative of the broader population. A prospective
study design could minimize such biases and provide stronger evidence.
-Although the use of matching methods helps control for some confounders, the reliance on
convenience sampling limits the generalizability of the results. A more randomized sampling
approach would increase the external validity of the findings.
-The study focuses primarily on diagnostic accuracy without assessing the impact of the imaging
modalities on clinical outcomes such as treatment decisions, patient survival, or recurrence
rates. Long-term follow-up data would provide valuable insights into how multimodal imaging
influences therapeutic planning and patient prognosis.
-The study focuses on diagnostic accuracy but does not address the potential cost-effectiveness
of combining CT and MRI. Given that combining these imaging modalities could increase
healthcare costs, it would be useful to discuss whether the improvement in diagnostic accuracy
justifies the added expense, especially in resource-limited settings.
-While the discussion highlights statistical significance in diagnostic accuracy, it would be
beneficial to discuss the clinical significance of these findings more explicitly. For instance,
how much earlier could MRI potentially detect metastases compared to CT? Are there specific
subgroups of patients who would benefit most from MRI, such as those with small lesions or
early-stage metastases? Providing more context about how the differences in sensitivity and
specificity might translate to real-world clinical practice could make the results more tangible
for readers.
-The combined use of CT and MRI is mentioned as enhancing diagnostic accuracy, particularly
in detecting small lesions, but the discussion could elaborate further on why combining
these modalities leads to higher diagnostic confidence. It would also be helpful to explore
potential drawbacks or challenges in clinical practice when using combined imaging (e.g., added
costs, increased time for interpretation, or patient burden) and how these could be addressed.
Discussing the specific benefits of combining both modalities could strengthen the argument
for adopting this approach.
assistant