title: Benefit of Contrast-Enhanced Ultrasound (CEUS) in the Follow-Up Care of Patients with Colon Cancer: A Prospective Multicenter Study.
abstract: OBJECTIVE
  According to the German guidelines on colorectal cancer, unenhanced ultrasound is recommended for follow-up. On the other hand, ultrasound and radiology societies specify the use of contrast-enhanced ultrasound for ruling out liver metastases. Studies focusing on the follow-up of cancer patients are lacking. The goal of this multicenter study initiated by the German Ultrasound Society (DEGUM) was to determine the potential benefit of contrast-enhanced ultrasound in the follow-up of patients with colon cancer.
  
  
  METHODS
  Follow-up patients with colon cancer (UICC > IIa) were investigated. As scheduled according to the German guidelines, unenhanced ultrasound was performed followed by contrast-enhanced ultrasound. All liver lesions were recorded. In case of additional metastases detected on contrast-enhanced ultrasound, contrast-enhanced CT, MRI or biopsy was performed to confirm additional liver metastases.
  
  
  RESULTS
  A total of 45 liver metastases were detected in 26/290 patients (= 9 %) using unenhanced ultrasound. A further 28 metastases were detected on contrast-enhanced ultrasound in these 26 patients. In 18 patients showing no liver metastases, 40 additional metastases were detected on unenhanced ultrasound. This means that 44 patients with a total of 113 liver metastases were detected on contrast-enhanced ultrasound (p = 0.0006).
  
  
  CONCLUSIONS
  Contrast-enhanced ultrasound should be recommended in the follow-up of patients with colon cancer in addition to unenhanced ultrasound - the up-to-date standard.
authors.affiliation: Dept. of Internal Medicine, Kreisklinik Ebersberg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Bernatik
authors.affiliation: Dept. of Internal Medicine, Helfenstein Klinik, Geislingen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Schuler
authors.affiliation: Dept. of Internal Medicine, KH Villingen-Schwenningen, Villingen-Schwenningen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Kunze
authors.affiliation: Dept. of Internal Medicine, Kreisklinik Sigmaringen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Mauch
authors.affiliation: Dept. of Internal Medicine2, Caritas-Krankenhaus, Bad Mergentheim, Germany.
authors.forename: C F
authors.initials: CF
authors.lastname: Dietrich
authors.affiliation: Dept. of Internal Medicine, Rems-Murr-Klinik, Winnenden, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Dirks
authors.affiliation: Dept. of Internal Medicine, Israelisches Krankenhaus, Hamburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Pachmann
authors.affiliation: MED Facharztzentrum, Gastroenterologische Praxis, Mainz, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Börner
authors.affiliation: Dept. of Internal Medicine1, university, Lübeck, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Fellermann
authors.affiliation: Dept. of Internal Medicine2, Klinikum Ingolstadt, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Menzel
authors.affiliation: Dept. of Medicine 1, University of Erlangen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Strobel
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D010743:Phospholipids; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013459:Sulfur Hexafluoride; D036542:Tomography, Spiral Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride