Contrast-enhanced intraoperative ultrasonography using perfluorobutane microbubbles for the enumeration of colorectal liver metastases.

Abstract

BACKGROUND:

Intraoperative ultrasonography (IOUS) is considered the standard for the identification of liver metastases. Use of lipid-stabilized perfluorobutane microbubbles as an ultrasound contrast agent may improve this. The value of contrast-enhanced IOUS (CE-IOUS) in enumerating colorectal liver metastases was studied here.

METHODS:

CE-IOUS was performed in consecutive resections for colorectal liver metastases in 2007-2010. All patients underwent preoperative computed tomography. Magnetic resonance imaging was not carried out routinely. Conventional intraoperative examination including IOUS, and CE-IOUS with peripherally injected contrast were performed. The histopathological findings and 6-month follow-up images were used as the reference standard.

RESULTS:

The study group of 102 patients had a total of 315 lesions identified on preoperative imaging (2·4 lesions per operation; 129 operations). Conventional intraoperative examination including IOUS identified 350 lesions (2·7 per operation). CE-IOUS identified 370 lesions (2·9 per operation). The sensitivity, specificity and accuracy of CE-IOUS were 97·1, 59·1 and 93·2 per cent respectively. The CE-IOUS findings altered the surgical plan in 19 operations (14·7 per cent).

CONCLUSION:

CE-IOUS provided additional information to that obtained using contemporary preoperative imaging and conventional intraoperative examinations.

• Authors: M Takahashi, K Hasegawa, J Arita, S Hata, T Aoki, Y Sakamoto, Y Sugawara, N Kokudo
• Journal: The British journal of surgery (Br J Surg) Vol. 99 Issue 9 Pg. 1271-7 (Sep 2012) ISSN: 1365-2168 [Electronic] England
• PMID: 22829436 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Chemical References

• Contrast Media
• Fluorocarbons
• perfluorobutane

Topics

• Adult
• Aged
• Aged, 80 and over
• Colorectal Neoplasms
• Contrast Media
• Female
• Fluorocarbons
• Humans
• Intraoperative Care (methods)
• Liver Neoplasms (diagnostic imaging, secondary, surgery)
• Male
• Microbubbles
• Middle Aged
• Sensitivity and Specificity
• Ultrasonography