Prospective serial ultrasound scanning (U/S) of the liver at 3-monthly intervals has been used to detect the presence of hepatic
metastases from successfully resected Dukes' A, B and C grade
colorectal carcinomas in a trial of the antimetastatic agent
razoxane (
ICRF 159). One hundred and twenty-six consecutive patients were randomly allocated to either adjuvant
razoxane treatment (61) or to no further treatment (65). Twenty-six patients, 15 in the control group (23 per cent) and 11 in the
razoxane treatment group (18 per cent) have developed hepatic
metastases. All but three patients in the treated group and four in the controls were detected by U/S. In the control group four patients had definite
metastases when
metastases were first seen by ultrasound and three more, among the eight who initially had probable
metastases, became definite
metastases on ultrasound. In the treated group four patients had definite
metastases and four more developed them amongst 12 who had probable
metastases. The remaining eight of these 12 all regressed completely. This compared with only one complete regression (additionally on 5-FU for lung secondaries) amongst the eight controls who had probable
metastases. The median time to development of liver
metastases detected by U/S and other means was 59 weeks in the control group and 91 weeks in the
razoxane treatment group. Ultrasound has proved to be a safe, sensitive and acceptable serial imaging technique for detecting colorectal liver
metastases. Used prospectively, U/S has been valuable in monitoring the natural history of liver
metastases and their behaviour during
razoxane treatment.