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Intraoperative Ultrasound Better Than CT or PET In Detecting Liver Metastases: Presented at SSO

By Crystal Phend

SAN DIEGO, C.A. -- March 27, 2006 -- Intraoperative ultrasound is more accurate than computed tomography (CT), CT angioportogram and positron emission tomography (PET) imaging, according to research presented here at the annual meeting of the Society of Surgical Oncology (SSO).

"Intraoperative ultrasound still remains the gold standard," said lead author Mehul Patel, MD, medical resident, McLaren Regional Medical Center, Flint, Michigan, United States, in a presentation March 24^th.

Until now, data comparing the three types of imaging in patients with liver cancer were scarce. The issue is important, Dr. Patel said, because percutaneous radiofrequency ablation requires preoperative localization of liver metastases, which does not allow for intraoperative ultrasound. "The efficacy of percutaneous radiofrequency ablation thus may be limited due to its inability to perform intraoperative ultrasound," Dr. Patel said.

His team conducted a retrospective chart review of 53 patients who underwent surgery to remove liver metastases. The same surgical oncologist treated all patients, and they all had preoperative CT scan. Of these, 24 also received a preoperative PET scan, 39 had intraoperative ultrasound, and 28 had a CT angioportogram.

Twenty-four had the combination of CT scan, PET scan and intraoperative ultrasound; 21 received the combination of CT angioportogram and intraoperative ultrasound; \13 had CT angioportogram, PET and intraoperative ultrasound.

Results of the chart review show that intraoperative ultrasound found the most lesions per patient (2.6), followed by CT scan (2.4), CT angioportogram (2.0), and PET scan (1.7).

When combined, preoperative CT and PET found 2.3 lesions per patient compared with 2.8 with intraoperative ultrasound alone. Intraoperative imaging found additional lesions in 33%, fewer lesions in 17%, and the same number of lesions in 50% compared to preoperative imaging.

The combination of CT angioportogram and PET found the same 2.4 lesions per patient as intraoperative ultrasound. Intraoperative imaging found more lesions than this preoperative combination in 15.4% of patients and fewer lesions in another 15.4%.

Dr. Patel and his colleagues concluded that intraoperative ultrasound was more effective than any single preoperative imaging method and is thus more cost effective.


[Presentation title: Comparative Analysis of CT-scan, CT Angioportogram and PET-scan with Intraoperative Ultrasound in Detecting Liver Metastases. Poster 70]

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