title: Real time contrast enhanced ultrasonography in detection of liver metastases from gastrointestinal cancer.
abstract: BACKGROUND
  Contrast enhanced ultrasound (CEUS) is an imaging technique which appeared on the market around the year 2000 and proposed for the detection of liver metastases in gastrointestinal cancer patients, a setting in which accurate staging plays a significant role in the choice of treatment.
  
  
  METHODS
  A total of 109 patients with colorectal (n = 92) or gastric cancer prospectively underwent computed tomography (CT) scan and conventional US evaluation followed by real time CEUS. A diagnosis of metastases was made by CT or, for lesions not visible at CT, the diagnosis was achieved by histopathology or by a malignant behavior during follow-up.
  
  
  RESULTS
  Of 109 patients, 65 were found to have metastases at presentation. CEUS improved sensitivity in metastatic livers from 76.9% of patients (US) to 95.4% (p <0.01), while CT scan reached 90.8% (p = n.s. vs CEUS, p < 0.01 vs US). CEUS and CT were more sensitive than US also for detection of single lesions (87 with US, 122 with CEUS, 113 with CT). In 15 patients (13.8%), CEUS revealed more metastases than CT, while CT revealed more metastases than CEUS in 9 patients (8.2%) (p = n.s.).
  
  
  CONCLUSIONS
  CEUS is more sensitive than conventional US in the detection of liver metastases and could be usefully employed in the staging of patients with gastrointestinal cancer. Findings at CEUS and CT appear to be complementary in achieving maximum sensitivity.
authors.affiliation: Division Internal Medicine, Azienda Ospedaliero-Universitaria S, Orsola-Malpighi, Bologna, Italy. fabio.piscaglia@unibo.it
authors.forename: Fabio
authors.initials: F
authors.lastname: Piscaglia
authors.forename: Francesco
authors.initials: F
authors.lastname: Corradi
authors.forename: Mikaela
authors.initials: M
authors.lastname: Mancini
authors.forename: Francesco
authors.initials: F
authors.lastname: Giangregorio
authors.forename: Stefano
authors.initials: S
authors.lastname: Tamberi
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Ugolini
authors.forename: Bruno
authors.initials: B
authors.lastname: Cola
authors.forename: Alberto
authors.initials: A
authors.lastname: Bazzocchi
authors.forename: Roberto
authors.initials: R
authors.lastname: Righini
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pini
authors.forename: Fabio
authors.initials: F
authors.lastname: Fornari
authors.forename: Luigi
authors.initials: L
authors.lastname: Bolondi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media