BACKGROUND: The present study was designed to evaluate the role of intraoperative ultrasound (IOUS) in intrahepatic staging and the impact on surgical strategy for patients with colorectal liver metastases (CRLM). METHODS: The study included 515 patients who had undergone liver resection for CRLM at two tertiary care referral centers. Data from a prospectively collected database were retrospectively analysed. Early intrahepatic recurrence was assessed at 3 and 6 months after resection and was considered as residual disease undetected by IOUS. Performance of imaging modalities was compared by analysis of studies on individual patients. RESULTS: A total of 1,370 liver metastases were detected preoperatively with a median of 3 imaging modalities. MRI and PET were performed in 51 and 42 % of the patients, respectively. Median number of days between last imaging and surgery was 18. Contrast-enhanced IOUS was performed in 136 patients (26.4 %). Intraoperatively, 293 new nodules were found in 132 patients: on histology 280 were CRLM (17.6 %). Surgical strategy was changed in 140 patients (27.2 %). On multivariate analysis synchronous and bilobar metastases ≥ 3 in number, BMI ≥ 30, and time between last imaging and surgery longer than 18 days resulted in predictive factors indicating new nodules detected by IOUS. Early intrahepatic recurrences were 3.7 and 7.9 % at 3 and 6 months. Performance of CT, MRI, FDG-PET, and intraoperative staging was compared: sensitivity was 63.6, 68.8, 53.6, and 92 % and specificity was 91, 92.3, 95.8, and 97.8 %, respectively CONCLUSIONS: The use of IOUS continues to be mandatory for correct staging of patients with CRLM undergoing liver resection.
BACKGROUND: The present study was designed to evaluate the role of intraoperative ultrasound (IOUS) in intrahepatic staging and the impact on surgical strategy for patients with colorectal liver metastases (CRLM). METHODS: The study included 515 patients who had undergone liver resection for CRLM at two tertiary care referral centers. Data from a prospectively collected database were retrospectively analysed. Early intrahepatic recurrence was assessed at 3 and 6 months after resection and was considered as residual disease undetected by IOUS. Performance of imaging modalities was compared by analysis of studies on individual patients. RESULTS: A total of 1,370 liver metastases were detected preoperatively with a median of 3 imaging modalities. MRI and PET were performed in 51 and 42 % of the patients, respectively. Median number of days between last imaging and surgery was 18. Contrast-enhanced IOUS was performed in 136 patients (26.4 %). Intraoperatively, 293 new nodules were found in 132 patients: on histology 280 were CRLM (17.6 %). Surgical strategy was changed in 140 patients (27.2 %). On multivariate analysis synchronous and bilobar metastases ≥ 3 in number, BMI ≥ 30, and time between last imaging and surgery longer than 18 days resulted in predictive factors indicating new nodules detected by IOUS. Early intrahepatic recurrences were 3.7 and 7.9 % at 3 and 6 months. Performance of CT, MRI, FDG-PET, and intraoperative staging was compared: sensitivity was 63.6, 68.8, 53.6, and 92 % and specificity was 91, 92.3, 95.8, and 97.8 %, respectively CONCLUSIONS: The use of IOUS continues to be mandatory for correct staging of patients with CRLM undergoing liver resection.
Authors: Edward Leen; Piercarlo Ceccotti; Susan J Moug; Paul Glen; John MacQuarrie; Wilson J Angerson; Thomas Albrecht; Joachim Hohmann; Anja Oldenburg; Jorg Peter Ritz; Paul G Horgan Journal: Ann Surg Date: 2006-02 Impact factor: 12.969
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Authors: Shandra Bipat; Maarten S van Leeuwen; Emile F I Comans; Milan E J Pijl; Patrick M M Bossuyt; Aeilko H Zwinderman; Jaap Stoker Journal: Radiology Date: 2005-08-11 Impact factor: 11.105
Authors: Stephan M Wildi; Christoph Gubler; Thomas Hany; Henrik Petrowsky; Pierre A Clavien; Wolfram Jochum; Tilman Gerlach; Michael Fried; Beat Mullhaupt Journal: J Clin Ultrasound Date: 2008-01 Impact factor: 0.910
Authors: Luís Filipe Abreu de Carvalho; Bram Logghe; Stijn Van Cleven; Aude Vanlander; Suzane Moura Ribeiro; Karen Geboes; Clarisse Lecluyse; Peter Smeets; Helena Degroote; Hans Van Vlierberghe; Frederik Berrevoet Journal: Langenbecks Arch Surg Date: 2021-06-02 Impact factor: 3.445