RSNA 2014 

Abstract Archives of the RSNA, 2014


SSJ07-04

Detection of Liver Metastases Using a High Spatial Resolution Ultrasound Contrast Mode: Impact of Small Liver Metastases in Different Primary Malignancies

Scientific Papers

Presented on December 2, 2014
Presented as part of SSJ07: Gastrointestinal (Liver Masses)

Participants

Hans-Peter Weskott MD, Presenter: Luminary, General Electric Company Speaker, Bracco Group
Michael Hoepfner MD, Abstract Co-Author: Nothing to Disclose
Carsten Bohm, Abstract Co-Author: Nothing to Disclose

PURPOSE

Retrospective evaluation of the number and size distribution of liver metastases of different primaries by analyzing digitally stored triphasic CEUS loops of the liver in a two center study

METHOD AND MATERIALS

201patients with 287 CEUS examinations were included. US basic examination prior and after CEUS examination of 1.2mL Sonovue™  bolus injection (Bracco, Milan, Italy) in patients with metastatic liver disease. CEUS was performed in a pulse inversion technique (LOGIQ E9, GE Healthcare, Milwaukee, IL,USA). Patients were referred for CEUS with intention to treat,or for staging/restaging after chemotherapy or tumor resection. Representative loops of all triphasic CEUS examinations were digitally stored. At late phase, metastases were defined as washed out lesions and measured on still frames. Most frequent primaries: GI tract tumors (n=76, including 9 follow ups), breast cancer (n=89, 41 follow ups), melanoma (n=32, 9 follow ups). Size distibution was defined in 4 groups: Group 1: <5mm, group 2: 5.1mm -10mm, group 3: 11mm-20mm, group 4: >20mm.

RESULTS

In 287 examinations 3264 metastases were detected. Size distribution of all included patients: Group 1: 14.0%, 2: 37.9%, 3: 28.3%, 4: 19.8%. Patients with GI tract metastases (76 exams in 52 patients, 313 metastases) showed the largest metastases: Group 1: 4.0%, 2: 28.9%, 3: 31.1%, 4: 37.3%. Size distribution in breast cancer according to the four groups ( n=89 exams in 41 patients, 1526 metastases): Group 1: 22.5%, 2: 45.2%, 3: 22.2%, 4: 10.3%. Size distribution in melanoma group (32 exams in 20 patients, 337 metastases): Group 1: 19.2%, 2: 38.9%, 3: 31.5%, 4: 10.6%. Using high resolution CEUS technique small metastases down to 3mm in size could be detected.

CONCLUSION

CEUS is capable to detect also small metastases below 10mm accounting for 1/3 (GI tract) to 2/3 (breast cancer) of all metastases.

CLINICAL RELEVANCE/APPLICATION

Detection of especially small metastases is most important for the management of metastatic diseases. In patients with a high likelihood of liver metastases high resolution CEUS should be included early in the diagnostic work up. 

Cite This Abstract

Weskott, H, Hoepfner, M, Bohm, C, Detection of Liver Metastases Using a High Spatial Resolution Ultrasound Contrast Mode: Impact of Small Liver Metastases in Different Primary Malignancies.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14009420.html