CHICAGO — Contrast-enhanced intraoperative ultrasound identifies more liver tumors than does the imaging technology when it is used in a conventional manner, which may increase the chances for successful surgery or prevent unnecessary surgery, Marco Montorsi, M.D., said at the annual meeting of the Society for Surgery of the Alimentary Tract.
Dr. Montorsi, of the University of Milan, said he and his colleagues hoped to increase the tumor detection rate achieved with intraoperative ultrasound (IOUS), which has 82% sensitivity in detecting liver metastases from colorectal cancer.
From September 2003 to November 2004, 57 patients at the University of Milan had a liver resection and underwent both IOUS and the contrast-enhanced procedure, which involved 2.4 mL IV of sulfur-hexafluoride microbubbles.
Of the 57 patients, 34 had hepatocellular carcinoma (HCC), and 23 had colorectal metastases. Contrast-enhanced ultrasound provided new data about 21 of the 57 patients. For seven patients with HCC, the contrast did not confirm as malignant the new nodules found by conventional imaging. In these cases its use prevented surgery, Dr. Montorsi said. In four patients, contrast-enhanced ultrasound confirmed malignancies detected by IOUS, and in two it fully confirmed as HCC the additional lesions detected by IOUS.
In patients being evaluated for colorectal metastases, the contrast found new lesions missed by IOUS in four patients and confirmed additional lesions in three patients, Dr. Montorsi said.