BACKGROUND: Intraoperative ultrasonography (IOUS) is considered the standard for the identification of liver metastases. Use of lipid-stabilized perfluorobutane microbubbles as an ultrasound contrast agent may improve this. The value of contrast-enhanced IOUS (CE-IOUS) in enumerating colorectal liver metastases was studied here. METHODS: CE-IOUS was performed in consecutive resections for colorectal liver metastases in 2007-2010. All patients underwent preoperative computed tomography. Magnetic resonance imaging was not carried out routinely. Conventional intraoperative examination including IOUS, and CE-IOUS with peripherally injected contrast were performed. The histopathological findings and 6-month follow-up images were used as the reference standard. RESULTS: The study group of 102 patients had a total of 315 lesions identified on preoperative imaging (2·4 lesions per operation; 129 operations). Conventional intraoperative examination including IOUS identified 350 lesions (2·7 per operation). CE-IOUS identified 370 lesions (2·9 per operation). The sensitivity, specificity and accuracy of CE-IOUS were 97·1, 59·1 and 93·2 per cent respectively. The CE-IOUS findings altered the surgical plan in 19 operations (14·7 per cent). CONCLUSION: CE-IOUS provided additional information to that obtained using contemporary preoperative imaging and conventional intraoperative examinations.
BACKGROUND: Intraoperative ultrasonography (IOUS) is considered the standard for the identification of liver metastases. Use of lipid-stabilized perfluorobutane microbubbles as an ultrasound contrast agent may improve this. The value of contrast-enhanced IOUS (CE-IOUS) in enumerating colorectal liver metastases was studied here. METHODS: CE-IOUS was performed in consecutive resections for colorectal liver metastases in 2007-2010. All patients underwent preoperative computed tomography. Magnetic resonance imaging was not carried out routinely. Conventional intraoperative examination including IOUS, and CE-IOUS with peripherally injected contrast were performed. The histopathological findings and 6-month follow-up images were used as the reference standard. RESULTS: The study group of 102 patients had a total of 315 lesions identified on preoperative imaging (2·4 lesions per operation; 129 operations). Conventional intraoperative examination including IOUS identified 350 lesions (2·7 per operation). CE-IOUS identified 370 lesions (2·9 per operation). The sensitivity, specificity and accuracy of CE-IOUS were 97·1, 59·1 and 93·2 per cent respectively. The CE-IOUS findings altered the surgical plan in 19 operations (14·7 per cent). CONCLUSION: CE-IOUS provided additional information to that obtained using contemporary preoperative imaging and conventional intraoperative examinations.
Authors: Joost R van der Vorst; Boudewijn E Schaafsma; Merlijn Hutteman; Floris P R Verbeek; Gerrit-Jan Liefers; Henk H Hartgrink; Vincent T H B M Smit; Clemens W G M Löwik; Cornelis J H van de Velde; John V Frangioni; Alexander L Vahrmeijer Journal: Cancer Date: 2013-06-21 Impact factor: 6.860
Authors: Robert P Jones; Declan Dunne; Paul Sutton; Hassan Z Malik; Stephen W Fenwick; Monica Terlizzo; Elizabeth O'Grady; Claus Koelblinger; Stefan Stättner; Stefan Stremitzer; Thomas Gruenberger; Graeme J Poston Journal: HPB (Oxford) Date: 2012-10-16 Impact factor: 3.647