Preoperative evaluation of patients for liver resection. Appropriate CT imaging.
OBJECTIVE
The authors determined which combination of computed tomography scans is most helpful for preoperative assessment of patients with liver tumors.


BACKGROUND
Multi-institutional studies have shown that the most important prognostic factors for selection of patients with metastatic colorectal cancer considered for liver resection are: Dukes' stage of primary tumor, the number of hepatic metastases if greater than 3, the presence of extrahepatic cancer, and the ability to resect tumors with an adequate margin (> 1 cm.) Therefore the ability to predict the presence of extrahepatic disease and the number and location of hepatic tumors are important in these patients.


METHODS
One hundred and nine consecutive patients with evidence of hepatic tumors were evaluated by computed tomography with arterial portography (CTAP) and abdominal computed tomography after a 4-hour delay (CT-D). Results of these studies and conventional computed tomography (CT-C) were compared with findings at operation.


RESULTS
CTAP proved to be the most sensitive test for assessing distribution of intrahepatic disease. CT-D was no more sensitive than CT-C for the detection of hepatic or extrahepatic disease.


CONCLUSIONS
CT-C in concert with CTAP provides the most reasonable CT evaluation of patients considered for operation for the treatment of hepatic tumors.
Karl
R C
RC
Department of Surgery, College of Medicine, University of South Florida, Tampa.
Morse
S S
SS
Halpert
R D
RD
Clark
R A
RA
D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D011172:Portography; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*