Ablation of liver metastasis: is preoperative imaging sufficiently accurate?

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
J R WallaceE J Quebbeman

Abstract

The recent introduction of cryotherapy and radiofrequency ablation of liver metastasis has expanded the indications for treatment. As technology has advanced, a percutaneous approach has been developed. Percutaneous treatment, however, requires accurate preoperative imaging. From 1993 to 1999, 179 patients underwent operative exploration for treatment of suspected hepatic metastases from colorectal carcinoma. One hundred seventy-seven patients were staged by preoperative CT, two patients were staged by MRI, and complete data were available in 176. Hepatic tumor count by preoperative imaging was compared to intraoperative tumor count obtained by inspection, palpation, ultrasonographic examination using a 3.5/7.5 MHz T probe, and careful gross sectioning of the resected specimen. Post hoc analysis was performed on 35 CT scans by two radiologists who specialize in abdominal CT. These radiologists were blinded to the intraoperative findings. Their interpretations were compared to the intraoperative counts and to each other. Thirty-four (19%) of 179 patients were deemed untreatable at operation because of unsuspected overwhelming liver involvement in 11 (6%) or extrahepatic metastases in 23 (13%). For the group, CT was accurate in 8...Continue Reading

Citations

Nov 26, 2002·The British Journal of Surgery·I S TaitSir A Cuschieri
Apr 28, 2007·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·J KuligP Richter
Apr 14, 2005·Annals of Surgical Oncology·David L Morris
Jun 26, 2014·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Simon YangCalvin H L Law
Apr 18, 2002·AJR. American Journal of Roentgenology·John R LeyendeckerFrancis E Sharkey
Feb 3, 2009·The Surgical Clinics of North America·Brett Yamane, Sharon Weber
Dec 8, 2009·Current Problems in Surgery·Charles H ChaSharon M Weber

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