title: CT laparoscopy for detecting small superficial metastatic lesions of the liver surface: initial experience.
abstract: OBJECTIVE
  The purpose of this study was to determine the efficacy of CT laparoscopy in the detection of superficial metastasis of the liver surface.
  
  
  METHODS
  From April 1, 2007, to July 1, 2007, a total of 34 consecutively registered patients (19 men, 15 women; median age, 55 years) with various intraabdominal malignant tumors underwent preoperative CT and composed the study population. All patients underwent superparamagnetic iron oxide-enhanced MRI and portal phase contrast-enhanced 64-MDCT, including CT laparoscopy. CT laparoscopy is a form of volume-rendering 3D imaging of the liver that depicts the liver surface in detail.
  
  
  RESULTS
  Among 23 patients who underwent surgery for management of a primary tumor, four patients had seven superficial metastatic lesions of the liver surface. None of these lesions had been detected with preoperative axial CT or superparamagnetic iron oxide-enhanced MRI. In contrast, CT laparoscopy revealed four of seven lesions in four patients. On a lesion-by-lesion basis, the sensitivity was 57%, the positive predictive value was 100%, and the accuracy was 57%.
  
  
  CONCLUSIONS
  Our initial experience proves that CT laparoscopy is a promising method for detecting small superficial metastatic lesions of the liver surface. The findings can influence decisions regarding tumor resectability.
authors.affiliation: Department of Radiology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyoku, Kyoto 606-8507, Japan. mbo@kuhp.kyoto-u.ac.jp
authors.forename: Yoji S
authors.initials: YS
authors.lastname: Maetani
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Isoda
authors.forename: Akinori
authors.initials: A
authors.lastname: Nomura
authors.forename: Shigeki
authors.initials: S
authors.lastname: Arizono
authors.forename: Yuusuke
authors.initials: Y
authors.lastname: Hirokawa
authors.forename: Toshiya
authors.initials: T
authors.lastname: Shibata
authors.forename: Togashi
authors.initials: T
authors.lastname: Kaori
mesh_terms: D000368:Aged; D003287:Contrast Media; D004067:Digestive System Neoplasms / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol