Preoperative detection of hepatic metastases from colorectal cancer: Prospective comparison of contrast-enhanced ultrasound and multidetector-row computed tomography (MDCT)

Abstract Purpose The goal of this study was to prospectively compare the sensitivity of contrast-enhanced ultrasound (CEUS) with that of multiphase multidetector-row computed tomography (MDCT) in the preoperative detection of hepatic metastases. Materials and method Forty-eight patients, with a mean age of 62 years old (range: 43–85 years) were prospectively included. All patients underwent CEUS following intravenous administration of 2.4 mL of an ultrasound contrast agent (Sonovue ® , Bracco, Milan, Italy) and multiphase MDCT. Intraoperative ultrasound examination (IOUS) was used as the standard of reference. Results A total of 158 liver metastases were identified by IOUS, 127 by preoperative MDCT (sensitivity; 80.4%) and 102 by CEUS (sensitivity, 64.5%). The 15.9% difference in sensitivity between CEUS and MDCT was statistically significant ( P  = 0.002). There was a disagreement between IOUS and CEUS in 23 patients (47%) and in 13 patients (27%) between IOUS and MDCT. MDCT identified one or more additional metastases in 10 patients (20%) resulting in a change in the surgical strategy. Conclusion Based on an unselected patient cohort and using multiphase MDCT, CEUS is significantly inferior to MDCT for the preoperative detection of hepatic metastases of colorectal cancer.