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A meta-analysis evaluating contrast-enhanced intraoperative ultrasound (CE-IOUS) in the context of surgery for colorectal liver metastases

  • Hepatobiliary
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Background

This study aimed to assess the outcomes of contrast-enhanced intraoperative ultrasound (CE-IOUS) for patients with colorectal liver metastases (CRLMs) undergoing surgery.

Method

A thorough literature search was performed in PubMed, Scopus, and Cochrane databases, in accordance with the PRISMA guidelines. The Odds Ratio, Weighted Mean Difference, and 95% Confidence Interval were evaluated, by means of Random-Effects model.

Results

Eleven articles met the inclusion criteria and incorporated 497 patients. The present study shows that CE-IOUS is associated with higher sensitivity and accuracy compared with multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), and intraoperative ultrasound (IOUS) in identifying CRLMs (p < 0.05). The positive predictive value was similar among the different modalities. Furthermore, new CRLMs were identified by CE-IOUS, thus affecting the surgical plan in 128 patients (51.8% of the patients with new CRLMs). Moreover, 91 patients (71%) underwent a more extensive hepatectomy and 15 patients (11.7%) were considered non-operable. Two alternative contrast agents, Sonazoid and Sonovue, were employed with similar sensitivity (p > 0.05).

Conclusion

These outcomes suggest the superiority of the CE-IOUS over MDCT, MRI, and IOUS for the staging of patients with CRLMs undergoing surgery. However, they should be treated with caution given the small number of the included studies.

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Data availability

Raw data and material are available upon request. Supplementary electronic material is provided.

Code availability

Review Manager 5.4 was employed for the present study.

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Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Radiology, University of Thessaly, Biopolis, 41110, Larissa, Greece

    Maria P. Fergadi

  2. Division of Surgery and Interventional Science, Faculty of Medical Sciences, UCL, London, UK

    Dimitrios E. Magouliotis

  3. Department of Radiology, University of Thessaly, Biopolis, Larissa, Greece

    Marianna Vlychou & Christos Rountas

  4. Department of Surgery and Cancer, Imperial College London, St Mary’s Hospital, London, W2 1NY, UK

    Thanos Athanasiou

  5. Department of Surgery, University of Thessaly, Biopolis, 41110, Larissa, Greece

    Dimitrios E. Magouliotis & Dimitrios Zacharoulis

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Contributions

MPF contributed to the conception and design of the work, the acquisition, analysis, and interpretation of data for the work, the drafting the work and revising it critically for important intellectual content, the final approval of the version to be published and is accountable for all aspects of the work. DEM contributed to the design of the work, the interpretation of data for the work, the revising of the work critically for important intellectual content, the final approval of the version to be published and is accountable for all aspects of the work. MV contributed to the acquisition and analysis of data for the work, the drafting the work and revising it critically for important intellectual content, the final approval of the version to be published and is accountable for all aspects of the work. CR contributed to the acquisition and analysis of data for the work, the drafting the work and revising it critically for important intellectual content, the final approval of the version to be published and is accountable for all aspects of the work. TA contributed to the design of the work, the acquisition and analysis of data for the work, the drafting the work and revising it critically for important intellectual content, the final approval of the version to be published and is accountable for all aspects of the work. DZ contributed to the conception and design of the work, the interpretation of data for the work, the revising of the work critically for important intellectual content, the final approval of the version to be published and is accountable for all aspects of the work.

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Correspondence to Dimitrios Zacharoulis.

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Fergadi, M.P., Magouliotis, D.E., Vlychou, M. et al. A meta-analysis evaluating contrast-enhanced intraoperative ultrasound (CE-IOUS) in the context of surgery for colorectal liver metastases. Abdom Radiol 46, 4178–4188 (2021). https://doi.org/10.1007/s00261-021-03096-7

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  • DOI: https://doi.org/10.1007/s00261-021-03096-7

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