This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Scaife, C. L. Articles by Curley, S. A. Search for Related Content PubMed PubMed Citation Articles by Scaife, C. L. Articles by Curley, S. A.

Accuracy of Preoperative Imaging of Hepatic Tumors With Helical Computed Tomography

¹ Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 444, Houston, Texas 77030
² Department of Radiology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 57, Houston, Texas 77030

Correspondence: Address correspondence and reprint requests to: Steven A. Curley, MD; E-mail: scurley{at}mdanderson.org.

Background: The accuracy of preoperative computed tomography (CT) scans in the era of modern imaging techniques with helical, high-resolution CT has not been adequately assessed. We reviewed the data from our departmental prospective database with the hypothesis that intraoperative ultrasonography (IOUS) still detects more hepatic tumors than are evident on preoperative helical CT scans.

Methods: All patients who underwent surgical resection and/or radiofrequency ablation of primary or metastatic hepatic tumors between January 2001 and July 2002 were included in the review. All patients had preoperative helical CT imaging followed by hepatic IOUS. The number of malignant lesions and evidence of local disease identified by the preoperative CT scan versus IOUS and surgical exploration were compared.

Results: In this time period, 250 patients underwent surgical resection and/or radiofrequency ablation of hepatic tumors. In 67 (27%) of these patients, IOUS identified more hepatic tumors than were seen on preoperative helical CT scan. In eight patients (3%), CT underestimated local extension of the disease into the diaphragm. The incidence of inaccurate pre-operative prediction of the extent of disease increased significantly with a greater number of hepatic tumors.

Conclusions: IOUS identified additional hepatic tumors in 27% of patients who underwent hepatic resection after state-of-the-art preoperative CT imaging. This study provides evidence that IOUS remains an essential part of the complete assessment of hepatic malignancies in patients who receive surgical treatment.

Key Words: Liver imaging • Intraoperative ultrasonography • Preoperative CT scan • Liver resection

This article has been cited by other articles:

				Y.-s. Kim, H. Rhim, H. K. Lim, D. Choi, W. J. Lee, T. Y. Jeon, J. W. Joh, and S. J. Kim Intraoperative Radiofrequency Ablation for Hepatocellular Carcinoma: Long-Term Results in a Large Series Ann. Surg. Oncol., July 1, 2008; 15(7): 1862 - 1870. [Abstract] [Full Text] [PDF]