Title: Diagnostic performance of contrast-enhanced CT combined with contrast-enhanced MRI
for colorectal liver metastases: A case-control study
Version: 1 Date: 09 Feb 2025
Reviewer's report:
This manuscript presents a well-conducted case-control study evaluating the diagnostic
performance of contrast-enhanced CT and MRI in detecting colorectal liver metastases (CRLM).
The study design, methodology, and results are clearly presented, and the findings highlight
the significant improvement in diagnostic accuracy when combining both imaging modalities.
However, there still are some weaknesses should be revised.
1. Gadoterate meglumine (extracellular non-specific contrast agent) was used for enhanced MRI
in this study, however, hepatocyte-specific contrast agents is recommended in the guidelines
to improve the detection rate of metastatic lesions. Please explain in detail and compare with
previous literature.
2. The manuscript does not provide a detailed explanation of the gold standard criteria for
diagnosing liver metastases. Were all specimens obtained through surgical resection or biopsy?
3. In this study, the maximum b-value used for DWI was only 450 s/mm², and lower b-values
could potentially result in reduced sensitivity for detecting liver metastases.
3. Please specify the time interval between the administration of the two contrast agents. The
use of both CT and MRI contrast agents raises concerns about the increased risk of contrast
nephropathy, which is an important factor to consider in clinical practice.
4. While the study demonstrates improved diagnostic accuracy, the discussion could benefit
from a more detailed exploration of the clinical implications, such as how the combined imaging
approach might influence treatment decisions and patient outcomes.
5. The retrospective nature of the study may introduce selection bias. And, the study was
conducted at a single institution, which may limit the generalizability of the findings.
Title: Diagnostic performance of contrast-enhanced CT combined with contrast-enhanced MRI
for colorectal liver metastases: A case-control study
Version: 1 Date: 09 Feb 2025
Reviewer's report:
This manuscript presents a well-conducted case-control study evaluating the diagnostic
performance of contrast-enhanced CT and MRI in detecting colorectal liver metastases (CRLM).
The study design, methodology, and results are clearly presented, and the findings highlight
the significant improvement in diagnostic accuracy when combining both imaging modalities.
However, there still are some weaknesses should be revised.
1. Gadoterate meglumine (extracellular non-specific contrast agent) was used for enhanced MRI
in this study, however, hepatocyte-specific contrast agents is recommended in the guidelines
to improve the detection rate of metastatic lesions. Please explain in detail and compare with
previous literature.
2. The manuscript does not provide a detailed explanation of the gold standard criteria for
diagnosing liver metastases. Were all specimens obtained through surgical resection or biopsy?
3. In this study, the maximum b-value used for DWI was only 450 s/mm², and lower b-values
could potentially result in reduced sensitivity for detecting liver metastases.
3. Please specify the time interval between the administration of the two contrast agents. The
use of both CT and MRI contrast agents raises concerns about the increased risk of contrast
nephropathy, which is an important factor to consider in clinical practice.
4. While the study demonstrates improved diagnostic accuracy, the discussion could benefit
from a more detailed exploration of the clinical implications, such as how the combined imaging
approach might influence treatment decisions and patient outcomes.
5. The retrospective nature of the study may introduce selection bias. And, the study was
conducted at a single institution, which may limit the generalizability of the findings.
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: 09 Feb 2025
Reviewer's report:
This manuscript presents a well-conducted case-control study evaluating the diagnostic
performance of contrast-enhanced CT and MRI in detecting colorectal liver metastases (CRLM).
The study design, methodology, and results are clearly presented, and the findings highlight
the significant improvement in diagnostic accuracy when combining both imaging modalities.
However, there still are some weaknesses should be revised.
1. Gadoterate meglumine (extracellular non-specific contrast agent) was used for enhanced MRI
in this study, however, hepatocyte-specific contrast agents is recommended in the guidelines
to improve the detection rate of metastatic lesions. Please explain in detail and compare with
previous literature.
2. The manuscript does not provide a detailed explanation of the gold standard criteria for
diagnosing liver metastases. Were all specimens obtained through surgical resection or biopsy?
3. In this study, the maximum b-value used for DWI was only 450 s/mm², and lower b-values
could potentially result in reduced sensitivity for detecting liver metastases.
3. Please specify the time interval between the administration of the two contrast agents. The
use of both CT and MRI contrast agents raises concerns about the increased risk of contrast
nephropathy, which is an important factor to consider in clinical practice.
4. While the study demonstrates improved diagnostic accuracy, the discussion could benefit
from a more detailed exploration of the clinical implications, such as how the combined imaging
approach might influence treatment decisions and patient outcomes.
5. The retrospective nature of the study may introduce selection bias. And, the study was
conducted at a single institution, which may limit the generalizability of the findings.
assistant