Liver metastases on serial contrast-enhanced multidetector computed tomography examinations: was the detection possible on previous examinations?
OBJECTIVE
To verify the earliest detectability of liver metastases in patients who underwent serial multidetector computed tomography (MDCT) examinations.


METHODS
We selected 12 patients with known primary cancer who underwent 4 or more contrast-enhanced, 4-detector MDCTs. When metastases had been reported, an evaluation of the preceding MDCT was done to define whether the lesion was detectable, detectable only by minimal signs, undetectable, or detected but misdiagnosed as a benign lesion (MBL).


RESULTS
Eighty-eight lesions were analyzed. Evaluating the preceding examination, we defined detectable (n=8), detectable only by minimal signs (n=5), undetectable (n=74), and MBL (n=1). The group with minimal signs was composed of 4 small hypodense foci and 1 calcification. The MBL was a non-Hodgkin lesion first misdiagnosed as a hemangioma.


CONCLUSIONS
Approximately 15% of liver metastases were prospectively missed, 9% of them being retrospectively detectable, 6% being retrospectively visible as minimal signs, whereas only 1% of liver metastases were misdiagnosed as a benign lesion.
Tresoldi
Silvia
S
Department of Diagnostic and Interventional Radiology, University of Milan, San Paolo Hospital, Milan, Italy. silvia.3soldi@tin.it
Sardanelli
Francesco
F
Borzani
Irene
I
Flor
Nicola
N
Cornalba
Gianpaolo
G
D000368:Aged; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*