| Hepatic metastases from colorectal cancer: preoperative detection and assessment of resectability with helical CT. | |
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MedLine Citation:
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PMID: 11152779 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To prospectively evaluate helical computed tomography (CT) in the preoperative detection of hepatic metastases and assessment of resectability with surgical, intraoperative ultrasonographic (US), and histopathologic correlation. MATERIALS AND METHODS: Between October 1995 and December 1998, preoperative staging with helical CT (5-mm collimation; reconstruction interval, 5 mm) was performed in 157 patients with hepatic metastases. Iodinated contrast material was injected intravenously (160-170 mL; rate, 2.5-3.0 mL/sec); acquisition began at 60-70 seconds. Four radiologists prospectively assessed the metastatic involvement of the liver by indicating the number and location of the lesions; resection was indicated in 113 patients (119 instances). Helical CT findings were correlated with pathologic and surgical findings on a lesion-by-lesion basis. RESULTS: Intraoperative US, palpation, and histopathologic examination revealed 290 liver metastases; helical CT correctly depicted 247. Helical CT results were the following: overall detection rate, 85.1% (95% CI: 80.8%, 89.3%); positive predictive value, 96.1% (95% CI: 92.9%, 98.1%); and false-positive rate, 3.9% (10 of 257 findings; 95% CI: 1.9%, 7.1%). False-positive findings were related to hemangioendothelioma, hemangioma, hepatic peliosis, biliary adenoma, centrilobar hemorrhage, biliary hamartoma, periportal fibrosis, and normal liver parenchyma. Curative resection was performed in 112 instances with a resectability rate of 94.1%. Four-year patient survival rate was 58.6%. CONCLUSION: Helical CT is a noninvasive, reliable, and accurate technique for imaging the liver and should be considered as the standard preoperative work-up of hepatic metastases from colorectal cancer. |
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Authors:
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C Valls; E Andía; A Sánchez; A Gumà; J Figueras; J Torras; T Serrano |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Radiology Volume: 218 ISSN: 0033-8419 ISO Abbreviation: Radiology Publication Date: 2001 Jan |
Date Detail:
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Created Date: 2001-01-26 Completed Date: 2001-06-07 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0401260 Medline TA: Radiology Country: United States |
Other Details:
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Languages: eng Pagination: 55-60 Citation Subset: AIM; IM |
Affiliation:
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Institute of Diagnostic Imaging, Hospital Duran i Reynals, Ciutat Sanitària i Universitària de Bellvitge, Autovia de Castelldefels km 2,7, L'Hospitalet de Llobregat, 08907 Barcelona, Spain. carlosvalls@csub.scs.es |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Colorectal Neoplasms / radiography* False Negative Reactions False Positive Reactions Female Follow-Up Studies Humans Liver Neoplasms / secondary*, surgery Male Middle Aged Preoperative Care Prospective Studies Sensitivity and Specificity Tomography, X-Ray Computed* / methods |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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