Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 2/2007

01-02-2007 | Original Article

Contrast-enhanced ultrasonography to detect liver metastases

A prospective trial to compare transcutaneous unenhanced and contrast-enhanced ultrasonography in patients undergoing laparotomy

Authors: R. Konopke, S. Kersting, H. Bergert, A. Bloomenthal, J. Gastmeier, H. D. Saeger, A. Bunk

Published in: International Journal of Colorectal Disease | Issue 2/2007

Login to get access

Abstract

Background/aims

The advent of contrast-enhanced ultrasound (CEUS) has called into question the efficacy of standard ultrasonographic techniques. In this study, we evaluated B-mode and color-duplex imaging and CEUS in the detection of liver metastases, using intraoperative and histological findings as a reference.

Materials and methods

Before laparotomy, 108 patients suspected of having liver metastases were prospectively examined with B-mode and color-duplex imaging, followed by contrast-enhanced ultrasound (2.4 ml SonoVue). Patients with unresectable tumors (n=8) were excluded from the analysis. The sonographic diagnosis in the remaining 100 patients was compared to the intraoperative and histological findings.

Results/findings

CEUS improved the sensitivity for detecting liver lesions from 56.3% (B-mode) to 83.8% (CEUS) (p=0.004). In particular, the contrast agent led to an improvement in ultrasonographic detection in the following cases: nodular metastases smaller than one centimeter; after adjuvant chemotherapy; for tumors near the surface of the liver; and for lesions situated around the ligamentum teres.

Interpretation/conclusions

CEUS provides significant improvement in the detection of liver metastases, and should therefore, be performed routinely in the surveillance of cancer patients.
Literature
1.
Tocchi A, Mazzoni G, Brozzetti S, Miccini M, Cassini D, Bettelli E (2004) Hepatic resection in stage IV colorectal cancer: prognostic predictors of outcome. Int J Colorectal Dis 19:580–585CrossRefPubMed
2.
Konopke R, Saeger H-D (2003) Lebermetastasen: Diagnostik und Therapie 74:866–886
3.
Scheele J, Altendorf-Hofmann A, Grube T, Hohenberger W, Stangl R, Schmidt K (2001) Resection of colorectal liver metastases. What prognostic factors determine patient selection? Chirurg 72:547–560CrossRefPubMed
4.
Luque-de Leon E, Tsiotos GG, Balsiger B, Barnwell J, Burgart LJ, Sarr MG (1999) Staging laparoscopy for pancreatic cancer should be used to select the best means of palliation and not only to maximize the resectability rate. J Gastrointest Surg 3:111–117CrossRefPubMed
5.
6.
Adam R (2003) Chemotherapy and surgery. New perspectives on the treatment of unresectable liver metastases. Ann Oncol 14(Suppl 2):ii13–ii16CrossRefPubMed
7.
Nakamura S, Suzuki S, Baba S (1997) Resection of liver metastases of colorectal carcinoma. World J Surg 21:741–747CrossRefPubMed
8.
Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH (1999) Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis consecutive cases. Ann Surg 230:309–318CrossRefPubMed
9.
Nordlinger B, Guiguet M, Vaillant JC, Balladur P, Boudjema K, Bachellier P, Jaeck D (1996) Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer 77:1254–1262CrossRefPubMed
10.
Bernatik T, Strobel D, Hahn EG, Becker D (2001) Detection of liver metastases: comparison of contrast-enhanced wide-band harmonic imaging with conventional ultrasonography. J Ultrasound Med 20:509–515PubMed
11.
Eberhardt S, Choi P, Bach A, Funt S, Felderman H, Hann L (2003) Utility of sonography for small hepatic lesions found on computed tomography in patients with Cancer. J Ultrasound Med 22:335–343PubMed
12.
Jang HJ, Lim HK, Lee WJ, Kim SH, Kim KA, Kim EY (2000) Ultrasonographic evaluation of focal hepatic lesions: comparison of pulse inversion harmonic, tissue harmonic and conventional imaging techniques. J Ultrasound Med 19:293–299PubMed
13.
Fevery J, Baert AL, Marchal GM, Broeckaert L, De Groote J, Vantrappen G (1985) The value of computed tomography, ultrasonography, and peritoneoscopy with biopsy in the detection of liver metastases secondary to gastro-enterological tumors. Acta Gastroenterol Belg 48:105–110PubMed
14.
Schreve RH, Terpstra OT, Ausema L, Lameris JS, van Seijen AJ, Jeekel J (1984) Detection of liver metastases. A prospective study comparing liver enzymes, scintigraphy, ultrasonography and computed tomography. Br J Surg 71:947–949PubMed
15.
Dietrich Ch, Becker D (2002) Signalverstärkte Farbdopplersonographie des Abdomens. Byk Gulden, Konstanz
16.
Albrecht T (2003) Contrast medium-supported sonography of the liver—a challenge to German radiology. Rofo 175:889–891PubMed
17.
Hohmann J, Skrok J, Puls R, Albrecht T (2003) Characterization of fokal liver lesion with contrast-enhanced low MI real time ultrasound and SonoVue. Fortschr Röntgenstr 175:835–843CrossRef
18.
von Herbay A, Vogt C, Willers R, Haussinger D (2004) Real-time imaging with the sonographic contrast agent SonoVue: differentiation between benign and malignant hepatic lesions. J Ultrasound Med 23:1557–1568PubMed
19.
Youk JH, Kim CS, Lee JM (2003) Contrast-enhanced agent detection imaging. Value in the characterisation of focal hepatic lesions. J Ultrasound Med 22:910–987
20.
Solbiati L, Tonolini M, Cova L, Goldberg N (2001) The role of contrast-enhanced ultrasound in the detection of focal liver lesions. Eur Radiol 11(suppl 3):E15–E26CrossRefPubMed
21.
Hölscher AH, Stadler J (1989) Intraoperative Sonographie zum Nachweis occulter Lebermetastasen beim kolorektalen Carzinom. Langenbecks Arch Chir 374:363–369CrossRefPubMed
22.
Vogl TJ, Schwarz W, Blume S et al (2003) Preoperative evaluation of malignant liver tumours: comparison of unenhanced and SPIO (Revovist)-enhanced MR imaging with biphasic CTAP and intraoperative US. Eur Radiol 13:262–272PubMed
23.
Bokor D, Chambers JB, Rees PJ, Mant TG, Luzzani F, Spinazzi A (2001) Clinical safety of SonoVue, a new contrast agent for ultrasound imaging, in healthy volunteers and in patients with chronic obstructive pulmonary disease. Invest Radiol 36:104–109CrossRefPubMed
24.
Morel DR, Schwieger I, Hohn L, Terrettaz J, Llull JB, Cornioley YA, Schneider M (2000) Human pharmacokinetics and safety evaluation of SonoVue, a new contrast agent for ultrasound imaging. Invest Radiol 35:80–85CrossRefPubMed
25.
de Groot MC, van Zwieten-Boot BJ, van Grootheest AC (2004) Severe adverse reactions after the use of sulphur hexafluoride (SonoVue) as an ultrasonographic contrast agent. Ned Tijdschr Geneeskd 148:1887–1888PubMed
26.
27.
Wilson SR, Burns PN, Muradali D, Wilson JALai X (2000) Harmonic hepatic US with microbubbles contrast agent: initial experience showing improved characterization of hemangioma, hepatocellular carcinoma and metastases. Radiology 215:153–161PubMed
28.
Strobel D, Hoefer A, Martus P, Hahn EG, Becker D (2001) Dynamic contrast-enhanced power Doppler sonography improves the differential diagnosis of liver lesions. Int J Colorectal Dis 16:247–256CrossRefPubMed
29.
Basilico R, Blomley MJ, Harvey CJ et al (2002) Which continuous US scanning mode is optimal for the Detection of vascularity in liver lesions when enhanced with the second generation contrast agent. Eur J Radiol 41:184–191CrossRefPubMed
30.
Leen E (2001) The role of contrast-enhanced ultrasound in the characterisation of fokal liver lesions. Eur Radiol 11(suppl. 3):E27–E34CrossRefPubMed
31.
Kim TK, Choi BI, Han JK, Hong HS, Park SH, Moon SG (2000) Hepatic tumors: contrast agent-enhancement patterns with pulse-inversion harmonic US. Radiology 216:411–417PubMed
32.
Albrecht T, Blomley MJ, Burns PN et al (2003) Improved detection of hepatic metastases with pulse-inversio US during the liver-specific phase of SHU 508A: multicenter study. Radiology 227:361–370PubMed
33.
Bunk A, Stolben E, Konopke R, Nagel M, Saeger H-D (1998) Color Doppler sonography in liver surgery. Status of perioperative monitoring. J Ultrasound Med 19:202–212
34.
Gross M, Zoller WG (1995) Ultrasound criteria versus histology. Bildgebung 62:25–30PubMed
35.
Bernatik T, Becker D, Neureiter D et al (2003) Detection of liver metastases—comparison of contrast-enhanced ultrasound using first versus second generation contrast agents. J Ultrasound Med 24:175–179
36.
Konopke R, Kersting S, Saeger H-D, Bunk A (2005) Detection of liver lesions by contrast-enhanced ultrasound—comparison to intraoperative findings. Ultraschall Med 26:107–113CrossRefPubMed
37.
Schuessler G, Ignee A, Hirche T, Dietrich CF (2003) Improved detection and characterisation of liver tumors with echo-enhanced ultrasound. Z Gastroenterol 41:1167–1176CrossRefPubMed
38.
Lencioni R, Cioni D, Crocetti L et al (2002) Ultrasound imaging of focal liver lesions with a second-generation contrast Agent. Acad Radiol 9(suppl 2):371–374CrossRef
39.
Harvey CJ, Blomley MJ, Eckersley RJ, Heckemann RA, Butler-Barnes J, Cosgrove DO (2000) Pulse-inversion mode imaging of liver specific microbubbles: improved detection of subcentimetre metastases. Lancet 355:807–808CrossRefPubMed
40.
Dalla Palma L, Bertolotto M, Quaia E, Locatelli M (1999) Detection of liver metastases with pulse inversion harmonic imaging: preliminary results. Eur Radiol 9(suppl 3):382–387CrossRef
41.
Kockerling F, Schug-Pass C, Weskott HP, Tatchen R (2000) Malignant hepatobiliary tumors. Surgical requirement concerning preoperative diagnosis. Zentralbl Chir 125:616–623PubMed
Metadata
Title
Contrast-enhanced ultrasonography to detect liver metastases
A prospective trial to compare transcutaneous unenhanced and contrast-enhanced ultrasonography in patients undergoing laparotomy
Authors
R. Konopke
S. Kersting
H. Bergert
A. Bloomenthal
J. Gastmeier
H. D. Saeger
A. Bunk
Publication date
01-02-2007
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 2/2007
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-006-0134-5

Other articles of this Issue 2/2007

International Journal of Colorectal Disease 2/2007 Go to the issue

Original Article

Defecation mechanisms after anterior resection with J-pouch-anal and side-to-end anastomosis in dogs

Original Article

Prospective randomised trial comparing ileocaecal interposition and colon-J-pouch as rectal replacement after total mesorectal excision

Original Article

Prognostic factors of squamous cell carcinoma of the anal margin treated by radiotherapy: the Lyon experience

Original Article

Detection of micrometastases and skip metastases with ex vivo sentinel node mapping in carcinoma of the colon and rectum

Original Article

Microsatellite instability did not predict individual survival of unselected patients with colorectal cancer

Original Article

N-Acetyltransferase (NAT) 2 acetylator status and age of tumour onset in patients with sporadic and familial, microsatellite stable (MSS) colorectal cancer