Giovanni Morana MD, Presenter: Nothing to Disclose

Mirko D'Onofrio MD, Abstract Co-Author: Nothing to Disclose

Umberto Rozzanigo, Abstract Co-Author: Nothing to Disclose

Roberto Malagò, Abstract Co-Author: Nothing to Disclose

Niccolò Faccioli, Abstract Co-Author: Nothing to Disclose

Luigi Grazioli, Abstract Co-Author: Nothing to Disclose

to analyze the sensitivity of contrast enhanced (CE) CT, MR and US in identifying liver metastases.

30 Patients (19 males and 11 females; mean age 58 yrs; range 41-80) with gastrointestinal tumor were included in the study, because of clinical or radiological suspect of liver metastases, between May 2002 and December 2003. 20/30 had a colon cancer, 7/30 a pancreatic cancer, and 3/30 other tumors (ampulloma; stomach, lower esophagus). All patients were investigated with unenhanced US, CE-TC (Iopamidol 370 mg/ml; 120 ml @ 3 ml/sec), CE-MR (Gd-BOPTA; 0.1 mmol/Kg @ 2 ml/sec) CE-US (Sonovue, Bracco, Italy). Surgical exploration and intraoperative US, performed within 21 days the first examination, were used as reference standard. The statistical analysis of comparison between different methods was based on the McNemar test.

78 metastases (mean diameter 14.8 mm ± 10.9) were found in 23 patients; 39/78 (50%) metastases were small (<1cm). As a whole US identified 44/78 (56.4%) mets; CE-CT 54/78 (69.2%); CE-MR 67/78 (85.9%); CE-US 68/78 (87.1%). Considering only small metastases, detection rate was 11/39 (28.2%) for US and 13/39 (33.3%) for CE-CT versus 30/39 (76.9%) for CE-MR and 29/39 (74.3%) for CE-US. Combining information obtained both with US and CE-CT the sensitivity did not increased significantly (16/39: 41%).

The statistical analysis revealed no difference in the detection rate between US and CE-CT or between CE-MR and CE-US, whereas the sensitivity of CE-MR and CE-US was significantly superior to that of US and CE-CT, expecially for small metastases (p<0,0005).

Morana, G, D'Onofrio, M, Rozzanigo, U, Malagò, R, Faccioli, N, Grazioli, L, Sensitivity of Contrast-enhanced CT, MR, and US in Identifying Liver Metastases.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4406005.html