title: The value of intraoperative ultrasound and preoperative imaging, individually and in combination, in liver resection for metastatic colorectal cancer.
abstract: BACKGROUND
  Liver resection is proved to offer potential long-term survival for colorectal liver metastases (CRLM). Accurate radiological assessment is vital to enable an appropriate surgical approach. The role of intraoperative ultrasound (IOUS) has been controversial. This study was designed to analyse the accuracy of IOUS compared with that of preoperative imaging (POI) in these patients.
  
  
  METHODS
  A prospective analysis of 51 consecutive patients who underwent liver resection for CRLM was undertaken. The accuracy of POI and IOUS were correlated and compared with histopathological analysis. Statistical analyses included t-tests, to compare continuous variables, and chi-square and Fisher's exact tests to compare categorical variables. p<0.05 was considered significant
  
  
  RESULTS
  POI correlated with histology in 35 patients (68.6%). The sensitivity and specificity were 82.4% and 86.3% respectively. IOUS correlated with histology in 31 (60.8%) patients. The sensitivity and specificity were 84.3% and 76.5% respectively. There was no difference in accuracy between modalities. The accuracy of POI combined with IOUS correlated with histology in 40 patients (78.4%). The sensitivity and specificity were 88.2% and 84.3% respectively. The accuracy of combined modalities was significantly greater than IOUS or POI alone.
  
  
  CONCLUSIONS
  POI combined with IOUS may significantly increase the diagnostic accuracy of patients undergoing liver resection for CRLM.
authors.affiliation: Royal Surrey County Hospital, Guildford, UK. dr_lordan@yahoo.co.uk
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Lordan
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Stenson
authors.forename: Nariman D
authors.initials: ND
authors.lastname: Karanjia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms; D004812:Epidemiologic Methods; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography