Document Detail


Accuracy of investigations for asymptomatic colorectal liver metastases.
MedLine Citation:
PMID:  12006929     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim of this study was to prospectively assess the accuracy of the most promising imaging and tumor marker tests in liver metastasis diagnosis on follow-up of asymptomatic colorectal cancer patients during a median of 57 months after primary tumor resection. METHODS: One hundred patients, who were considered free of liver metastases after primary colorectal cancer resection and conventional follow-up, were screened for liver metastases by computerized tomography, magnetic resonance and ultrasound scans, ultrasound Doppler and isotope assessment of changes in hepatic arterial and portal venous flow, and serum estimation of carcinoembryonic antigen. Patients were followed up during a median of 41 months to identify those who developed liver metastases. RESULTS: The most sensitive technique was computerized tomography (sensitivity 0.67, specificity 0.91). Computerized tomography and magnetic resonance but not ultrasound were 100 percent accurate in differentiating liver metastases from other hepatic lesions. Techniques based on changes in hepatic arterial and portal venous flow had lower diagnostic accuracies (Doppler perfusion index, sensitivity 0.58, specificity 0.57; hepatic perfusion index, sensitivity 0.50, specificity 0.55), whereas ultrasound scanning identified only 43 percent (sensitivity 0.43, specificity 0.96) and serum carcinoembryonic antigen 33 percent (sensitivity 0.33, specificity 0.81) of patients with asymptomatic liver metastasis. Sensitivity could be improved by using tests in combination but this reduced specificity. CONCLUSIONS: Computerized tomography was the most sensitive test for asymptomatic colorectal liver metastases, but only 67 percent of affected patients were identified.
Authors:
C Glover; P Douse; P Kane; J Karani; H Meire; S Mohammadtaghi; T G Allen-Mersh
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  45     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-05-13     Completed Date:  2002-05-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  476-84     Citation Subset:  IM    
Affiliation:
Department of Surgery, Faculty of Medicine, Imperial College School of Science, Technology, and Medicine, Chelsea and Westminster Hospital, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Aged
Carcinoembryonic Antigen / blood
Carcinoma / blood,  diagnosis*,  secondary*
Colorectal Neoplasms / pathology*,  surgery*
Female
Follow-Up Studies
Humans
Liver Neoplasms / blood,  diagnosis*,  secondary*
Magnetic Resonance Imaging*
Male
Middle Aged
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Time Factors
Tomography, X-Ray Computed*
Ultrasonography, Doppler*
Chemical
Reg. No./Substance:
0/Carcinoembryonic Antigen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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