Background: The aim of the study was to define the specific diagnostic accuracy of different imaging techniques in patients (pts) with resectable colorectal cancer liver metastasis (CLMs). Methods: Consecutive pts with, potentially resectable CLMs afferent to the Multidisciplinary Liver Team of Bologna Sant’Orsola Malpighi Hospital performed, in the 3 weeks prior to liver surgery, computed tomography scan (CT), magnetic resonance diffusion-weighted (MR-DW), and liver contrast-enhanced ultrasonography (CEUS1). Liver contrast-enhanced ultrasonography was also performed intra-operatively (CEUS2). All the imaging exams were performed according to the standard operative procedures. Results: From December 2007 to December 2008, twenty-nine out of 50 pts enrolled in the PROMETEO study underwent liver resection. The pt characteristics were: 18 (62%) males, 11 (38%) females; 18 (62%) synchronous metastasis, 11 (38%) metachronous metastasis; 15 (51.7%) neoadjuvant chemotherapy; 7 (24.1%) previous liver surgery; 3 (10.3%) previous loco-regional treatment. Ninety-three liver lesions were resected; the median number lesions per patient was 2 (range 1- 10). All lesions were studied with CT and CEUS1, 90 (96.8%) with CEUS2, 83 (89.2%) with PET and 85 (91.4%) with MR-DW. Five lesions at pathological examination were non-metastasis (1 hamartoma, 1 steatosis, 1 giant-cell reaction, 2 necrosis). Only 3 lesions were not detected by all imaging techniques (in one pt. previously treated with chemotherapy and radiofrequency). Conclusions: These results show that CT, CEUS1 and MR-DW have a good accuracy in the detection of liver metastasis in patients who are candidates for resection. CEUS2 presents the best pathological predictive value.
Rojas Llimpe F, D.F.F. (2009). Presurgical comparative imaging evaluation in patients with colorectal cancer liver metastasis (PROMETEO Study). JOURNAL OF CLINICAL ONCOLOGY, 27, 1-1.
Presurgical comparative imaging evaluation in patients with colorectal cancer liver metastasis (PROMETEO Study)
Ercolani G;Golfieri R;
2009
Abstract
Background: The aim of the study was to define the specific diagnostic accuracy of different imaging techniques in patients (pts) with resectable colorectal cancer liver metastasis (CLMs). Methods: Consecutive pts with, potentially resectable CLMs afferent to the Multidisciplinary Liver Team of Bologna Sant’Orsola Malpighi Hospital performed, in the 3 weeks prior to liver surgery, computed tomography scan (CT), magnetic resonance diffusion-weighted (MR-DW), and liver contrast-enhanced ultrasonography (CEUS1). Liver contrast-enhanced ultrasonography was also performed intra-operatively (CEUS2). All the imaging exams were performed according to the standard operative procedures. Results: From December 2007 to December 2008, twenty-nine out of 50 pts enrolled in the PROMETEO study underwent liver resection. The pt characteristics were: 18 (62%) males, 11 (38%) females; 18 (62%) synchronous metastasis, 11 (38%) metachronous metastasis; 15 (51.7%) neoadjuvant chemotherapy; 7 (24.1%) previous liver surgery; 3 (10.3%) previous loco-regional treatment. Ninety-three liver lesions were resected; the median number lesions per patient was 2 (range 1- 10). All lesions were studied with CT and CEUS1, 90 (96.8%) with CEUS2, 83 (89.2%) with PET and 85 (91.4%) with MR-DW. Five lesions at pathological examination were non-metastasis (1 hamartoma, 1 steatosis, 1 giant-cell reaction, 2 necrosis). Only 3 lesions were not detected by all imaging techniques (in one pt. previously treated with chemotherapy and radiofrequency). Conclusions: These results show that CT, CEUS1 and MR-DW have a good accuracy in the detection of liver metastasis in patients who are candidates for resection. CEUS2 presents the best pathological predictive value.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
