Research article

Real time contrast enhanced ultrasonography in detection of liver metastases from gastrointestinal cancer

Fabio Piscaglia¹ , Francesco Corradi¹ , Mikaela Mancini¹ , Francesco Giangregorio² , Stefano Tamberi³ , Giampaolo Ugolini⁴ , Bruno Cola⁵ , Alberto Bazzocchi¹ , Roberto Righini¹ , Patrizia Pini¹ , Fabio Fornari² and Luigi Bolondi¹

¹Div. Internal Medicine, Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Bologna, Italy

²Div. Gastroenterology, Ospedale Pietro da Saliceto, Piacenza, Italy

³Div. Oncology, Ospedale Civile di Faenza, Italy

⁴Div. Emergency Surgery, Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Bologna, Italy

⁵Div. General Surgery, Azienda Ospedaliero-Universitaria S. Orsola-Malpighi, Bologna, Italy

author email corresponding author email

BMC Cancer 2007, 7:171doi:10.1186/1471-2407-7-171

Published:	3 September 2007

Abstract

Background

Contrast enhanced ultrasound (CEUS) is an imaging technique which appeared on the market around the year 2000 and proposed for the detection of liver metastases in gastrointestinal cancer patients, a setting in which accurate staging plays a significant role in the choice of treatment.

Methods

A total of 109 patients with colorectal (n = 92) or gastric cancer prospectively underwent computed tomography (CT) scan and conventional US evaluation followed by real time CEUS. A diagnosis of metastases was made by CT or, for lesions not visibile at CT, the diagnosis was achieved by histopathology or by a malignant behavior during follow-up.

Results

Of 109 patients, 65 were found to have metastases at presentation. CEUS improved sensitivity in metastatic livers from 76.9% of patients (US) to 95.4% (p <0.01), while CT scan reached 90.8% (p = n.s. vs CEUS, p < 0.01 vs US). CEUS and CT were more sensitive than US also for detection of single lesions (87 with US, 122 with CEUS, 113 with CT). In 15 patients (13.8%), CEUS revealed more metastases than CT, while CT revealed more metastases than CEUS in 9 patients (8.2%) (p = n.s.).

Conclusion

CEUS is more sensitive than conventional US in the detection of liver metastases and could be usefully employed in the staging of patients with gastrointestinal cancer. Findings at CEUS and CT appear to be complementary in achieving maximum sensitivity.