title: The role of intraoperative ultrasound for the assessment of the focal liver lesions in patients with colorectal cancer.
abstract: OBJECTIVE
  To evaluate the concordance between intraoperative ultrasound (IOUS) and abdominal ultrasound (US) for the characterization of focal liver lesions in patients with colorectal cancer, and to evaluate the way in which IOUS influences the initially established hepatic surgical protocol based on abdominal US only.
  
  
  METHODS
  In this prospective study 73 patients with colorectal cancer and focal liver lesions found during IOUS were included. Abdominal US and IOUS findings were compared. The initially established hepatic surgical protocol based on abdominal US only was recorded. All patients in whom IOUS influenced this protocol and the way in which this was influenced were recorded.
  
  
  RESULTS
  Of the 73 patients, 41 (56.2%) had focal liver lesions classified as malignant by IOUS. In 26 of the 73 patients (35.6%), there were discordances between abdominal US and IOUS. IOUS influenced the operative protocol in 9 of the 73 patients included in the study (12.3%), and in 8 of the 41 patients with malignant lesions (19.5%). IOUS influenced the operative protocol by cancelling the preoperative hepatic surgery decision by evidencing the additional multiple malignant focal liver lesions, following the classification of some lesions as benign or by demonstrating the non-resectable character of other lesions. IOUS also determined unplanned hepatic resections by detecting resectable malignant lesions undiagnosed by abdominal US, and extended or limited the scheduled hepatic surgery based on abdominal US only.
  
  
  CONCLUSIONS
  There were inconsistencies between IOUS and abdominal US, therefore in patients with colorectal cancer IOUS provided additional information about focal liver lesions. IOUS influenced the operative protocol and consequently, unnecessary liver surgery was avoided. Also, IOUS identified malignant resectable liver lesions which were undetected by abdominal US.
authors.affiliation: PhD student, "Iuliu Hatieganu" University of Medicine and Pharmacy, Scandia Imagistica, Cluj-Napoca, Romania. dr_damian_claudiu@yahoo.com.
authors.forename: Claudiu-Dumitru
authors.initials: CD
authors.lastname: Damian
authors.affiliation: 4th Internal Medicine Department, Railway University Hospital Cluj-Napoca, Romania.
authors.forename: Nicolae
authors.initials: N
authors.lastname: Rednic
authors.affiliation: Radiology and Imaging Department, Railway University Hospital Cluj-Napoca, Romania.
authors.forename: Doru
authors.initials: D
authors.lastname: Munteanu
authors.affiliation: 4th Surgical Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Mircea
authors.initials: M
authors.lastname: Cazacu
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007430:Intraoperative Care; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary*; D008297:Male; D018447:Medical Futility; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014463:Ultrasonography; D055815:Young Adult