title: Screening for liver metastases in women with mammary carcinoma: comparison of contrast-enhanced ultrasound and magnetic resonance imaging.
abstract: OBJECTIVE
  The objective of the present study was to compare conventional B-mode ultrasound (BMU), contrast-enhanced ultrasound (CEUS), and magnetic resonance imaging (MRI) in the detection of liver metastases at the primary staging and follow-up of women with histologically confirmed mammary carcinoma.
  
  
  METHODS
  Included in the study were 55 women (aged 57.5 ± 11.0 years, range 27-75 years; mean disease duration 57.5 months, range 5-168 months); of these, 17 women were examined as part of primary staging (staging group) and 38 women at follow-up (follow-up group). All patients underwent BMU (Philips HDI 5000), CEUS (Philips HDI 5000; 4.8 ml SonoVue), and MRI (Siemens Avanto 1.5 T) of the liver.
  
  
  RESULTS
  In the staging group (n = 17), a mass was detected by BMU in 24% (n = 4), by CEUS in 29% (n = 5), and by MRI in 47% (n = 8); masses suspicious for malignancy were identified in 6% of patients with BMU and in 12% each by CEUS and MRI. Malignancy was not confirmed in any case by cytology or surgery. In the follow-up group (n = 38), masses were identified by MRI in 53% of patients with suspicion of malignancy in 18%. Malignancy was confirmed in 16% of cases identified at MRI, in 13% of cases identified with CEUS, and in 11% of cases identified with BMU. The Pearson coefficients of correlation were r = .29 (P = .03) for MRI vs. BMU; r = .42 (P = .002) for MRI vs. CEUS; and r = .75 (P ≤ .001) for BMU vs. CEUS. With respect to malignancy, the Pearson coefficients of correlation were r = .40 (P = .099) for BMU vs. MRI and r = .71 (P = .0009) for CEUS vs. MRI.
  
  
  CONCLUSIONS
  Beginning in tumor stage III, the use of CEUS and MRI is associated with a significantly greater benefit in the detection of malignant tumors of the liver compared with conventional BMU. BMU appears to be adequate for primary staging and the follow-up of lower tumor stages.
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, 89081 Ulm, Germany.
authors.forename: Martin Mark
authors.initials: MM
authors.lastname: Hänle
authors.forename: Regina
authors.initials: R
authors.lastname: Thiel
authors.forename: Georg
authors.initials: G
authors.lastname: Saur
authors.forename: Richard Andrew
authors.initials: RA
authors.lastname: Mason
authors.forename: Sandra
authors.initials: S
authors.lastname: Pauls
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kratzer
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA