title: Impact of chemotherapy on the accuracy of computed tomography scan for the evaluation of colorectal liver metastases.
abstract: BACKGROUND
  The aim of this study was to determine the effect of chemotherapy on the accuracy of CT scan for the preoperative evaluation of colorectal liver metastases (LM).
  
  
  METHODS
  Between 1999 and 2005, 92 patients with less than six LM at diagnosis underwent surgery within four weeks of CT scan. Of these 92 patients, 60 had received chemotherapy before surgery (chemotherapy group), whereas 32 were operated without preoperative treatment (control group). Histological and surgical findings were compared with helical CT results.
  
  
  RESULTS
  On a per lesion basis, the sensitivity of CT scan for the detection of LM was 71% in the chemotherapy group and 76% in the control group. On a per patient basis, the sensitivity of CT scan was 54% in the chemotherapy group and 69% in the control group. Discrepancies between CT scan and surgical or histological findings, including both false-negative and false-positive lesions, were found in 32 patients from the chemotherapy group and 10 patients from the control group (p=0.0471). In multivariate analysis, chemotherapy (p=0.032), number of LM > 3 (p=0.034), and steatosis > 30% (p=0.012) were risk factors for inadequate staging of LM by CT scan.
  
  
  CONCLUSIONS
  Chemotherapy reduces the accuracy of CT scan for preoperative evaluation of colorectal LM.
authors.affiliation: Department of Surgery, AP-HP, Hôpital Ambroise Paré, Boulogne, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Angliviel
authors.forename: Stéphane
authors.initials: S
authors.lastname: Benoist
authors.forename: Christophe
authors.initials: C
authors.lastname: Penna
authors.forename: Mostafa
authors.initials: M
authors.lastname: El Hajjam
authors.forename: Sophie
authors.initials: S
authors.lastname: Chagnon
authors.forename: Catherine
authors.initials: C
authors.lastname: Julié
authors.forename: Alain
authors.initials: A
authors.lastname: Beauchet
authors.forename: Philippe
authors.initials: P
authors.lastname: Rougier
authors.forename: Bernard
authors.initials: B
authors.lastname: Nordlinger
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents