Skip to main content

Advertisement

SpringerLink
Log in

Comparison of laparoscopic ultrasound and liver-specific magnetic resonance imaging for staging colorectal liver metastases

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Intraoperative liver ultrasound appears superior to liver-specific contrast-enhanced magnetic resonance imaging (MRI) to stage colorectal liver metastases (CRLMs). Most of the data come from studies on open surgery. Laparoscopic ultrasound (LUS) is technically demanding and its reliability is poor investigated. Aim of the study was to assess the accuracy of LUS staging for CRLMs compared to MRI.

Methods

All patients with CRLMs scheduled for laparoscopic liver resection (LLR) between 01/2010 and 06/2019 who underwent preoperative MRI were considered for the study. LUS and MRI performance was compared on a patient by patient basis. Reference standards were final pathology and 6 months follow-up results.

Results

Amongst 189 LLR for CRLMs, 146 met inclusion criteria. Overall, 391 CRLMs were preoperatively detected by MRI. 24 new nodules in 16 (10.9%) patients were found by LUS and resected. Median diameter of new nodules was 5.5 mm (2–10 mm) and 10 (41.6%) were located in the hepatic dome. Pathology confirmed 17 newly detected malignant nodules (median size 4 mm) in 11 (7.5%) patients. Relationships between intrahepatic vessels and tumours differed between LUS and MRI in 9 patients (6.1%). Intraoperative surgical strategy changed according LUS findings in 19 (13%) patients, requiring conversion to open approach in 3 (15.8%) of them. The sensitivity of LUS was superior to MRI (93.1% vs 85.6% whilst specificity was similar (98.6% MRI vs 96.5% LUS).

Conclusions

Laparoscopic liver ultrasound improves liver staging for CRLMs compared to liver-specific MRI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Adam R, De Gramont A, Figueras J, Guthrie A, Kokudo N, Kunstlinger F, Loyer E, Poston G, Rougier P, Rubbia-Brandt L, Sobrero A, Tabernero J, Teh C, Van Cutsem E, Vauthey JN, EGOSLIM (Expert Group on OncoSurgery management of LIver Metastases) group (2012) The oncosurgery approach to managing liver metastases from colorectal cancer: a multidisciplinary international consensus. Oncologist 17:1225–1239

    Article  CAS  Google Scholar 

  2. Xu LH, Cai SJ, Cai GX, Peng WJ (2011) Imaging diagnosis of colorectal liver metastases. World J Gastroenterol 17:4654–4659

    Article  Google Scholar 

  3. Hoch G, Croise-Laurent V, Germain A, Brunaud L, Bresler L, Ayav A (2015) Is intraoperative ultrasound still useful for the detection of colorectal cancer liver metastases? HPB (Oxford) 17:514–519

    Article  Google Scholar 

  4. Torzilli G, Botea F, Donadon M, Cimino M, Procopio F, Pedicini V, Poretti D, Montorsi M (2014) Criteria for the selective use of contrast-enhanced intra-operative ultrasound during surgery for colorectal liver metastases. HPB (Oxford) 16:994–1001

    Article  Google Scholar 

  5. Hoareau J, Venara A, Lebigot J, Hamel JF, Lermite E, Caroli-Bosc FX, Aube C (2016) Intraoperative contrast-enhanced ultrasound in colorectal liver metastasis surgery improves the identification and characterization of nodules. World J Surg 40:190–197

    Article  Google Scholar 

  6. Ferrero A, Langella S, Giuliante F, Viganò L, Vellone M, Zimmitti G, Ardito F, Nuzzo G, Capussotti L (2013) Intraoperative liver ultrasound still affects surgical strategy for patients with colorectal metastases in the modern era. World J Surg 37:2655–2663

    Article  Google Scholar 

  7. Schulz A, Dormagen JB, Drolsum A, Bjørnbeth BA, Labori KJ, Kløw NE (2012) Impact of contrast-enhanced intraoperative ultrasound on operation strategy in case of colorectal liver metastasis. Acta Radiol 53:1081–1087

    Article  Google Scholar 

  8. Langella S, Ardito F, Russolillo N, Panettieri E, Perotti S, Mele C, Giuliante F, Ferrero A (2019) Intraoperative ultrasound staging for colorectal liver metastases in the era of liver-specific magnetic resonance imaging: is it still worthwhile? J Oncol 2019:1369274

    Article  Google Scholar 

  9. Chen L, Zhang J, Zhang L, Bao J, Liu C, Xia Y, Huang X, Wang J (2012) Meta-analysis of gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imagingfor the detection of liver metastases. PLoS ONE 7:e48681

    Article  CAS  Google Scholar 

  10. Mao Y, Chen B, Wang H, Zhang Y, Yi X, Liao W, Zhao L (2020) Diagnostic performance of magnetic resonance imaging for colorectal liver metastasis: a systematic review and meta-analysis. Sci Rep 10:1969

    Article  CAS  Google Scholar 

  11. Macera A, Lario C, Petracchini M, Gallo T, Regge D, Floriani I, Ribero D, Capussotti L, Cirillo S (2013) Staging of colorectal liver metastases after preoperative chemotherapy. Diffusion-weighted imaging in combination with Gd-EOB-DTPA MRI sequences increases sensitivity and diagnostic accuracy. Eur Radiol 23:739–747

    Article  Google Scholar 

  12. Niekel MC, Bipat S, Stoker J (2010) Diagnostic imaging of colorectal liver metastases with CT, MR imaging, FDG PET, and/or FDG PET/CT: a meta-analysis of prospective studies including patients who have not previously undergone treatment. Radiology 257:674–684

    Article  Google Scholar 

  13. van Kessel CS, Buckens CF, van den Bosch MA, van Leeuwen MS, van Hillegersberg R, Verkooijen HM (2012) Preoperative imaging of colorectal liver metastases after neoadjuvant chemotherapy: a meta-analysis. Ann Surg Oncol 19:2805–2813

    Article  Google Scholar 

  14. Arita J, Ono Y, Takahashi M, Inoue Y, Takahashi Y, Matsueda K, Saiura A (2015) Routine preoperative liver-specific magnetic resonance imaging does not exclude the necessity of contrast-enhanced intraoperative ultrasound in hepatic resection for colorectal liver metastasis. Ann Surg 262:1086–1091

    Article  Google Scholar 

  15. Ciria R, Cherqui D, Geller DA, Briceno J, Wakabayashi G (2016) Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing. Ann Surg 263:761–777

    Article  Google Scholar 

  16. Viganò L, Ferrero A, Amisano M, Russolillo N, Capussotti L (2013) Comparison of laparoscopic and open intraoperative ultrasonography for staging liver tumors. Br J Surg 100:535–542

    Article  Google Scholar 

  17. Zhu P, Liao W, Ding ZY, Luo HC, Zhang BH, Zhang WG, Zhang W, Zhang ZG, Zhang BX, Chen XP (2018) Intraoperative ultrasonography of robot-assisted laparoscopic hepatectomy: initial experiences from 110 consecutive cases. Surg Endosc 32:4071–4077

    Article  Google Scholar 

  18. van Vledder MG, Pawlik TM, Munireddy S, Hamper U, de Jong MC, Choti MA (2010) Factors determining the sensitivity of intraoperative ultrasonography in detecting colorectal liver metastases in the modern era. Ann Surg Oncol 17:2756–2763

    Article  Google Scholar 

  19. Luetkens JA, Kupczyk PA, Doerner J, Fimmers R, Willinek WA, Schild HH, Kukuk GM (2015) Respiratory motion artefacts in dynamic liver MRI: a comparison using gadoxetate disodium and gadobutrol. Eur Radiol 25:3207–3213

    Article  Google Scholar 

  20. Takahashi M, Hasegawa K, Arita J, Hata S, Aoki T, Sakamoto Y, Sugawara Y, Kokudo N (2012) Contrast-enhanced intraoperative ultrasonography using perfluorobutane microbubbles for the enumeration of colorectal liver metastases. Br J Surg 99:1271–1277

    Article  CAS  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of General and Oncological Surgery, Umberto I Mauriziano Hospital, Largo Turati 62, 10128, Turin, Italy

    Nadia Russolillo, Alessandro Borello, Serena Langella, Michele Casella, Roberto Lo Tesoriere & Alessandro Ferrero

Authors
  1. Nadia Russolillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alessandro Borello
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Serena Langella
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michele Casella
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Roberto Lo Tesoriere
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alessandro Ferrero
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Drs. Nadia Russolillo, Alessandro Borello, Serena Langella, Michele Casella, Roberto Lo Tesoriere, Alessandro Ferrero, meet all of the conditions of the Authorship Criteria Published in the Consensus Statement on Submission and Publication of Manuscripts (2001 Surgical Endoscopy, page 537) and have approved the final article. Data for the current study are owned by the Department of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy. Authors have full control of all primary data. Data may be requested to the corresponding author.

Corresponding author

Correspondence to Nadia Russolillo.

Ethics declarations

Disclosure

Drs. Nadia Russolillo, Alessandro Borello, Serena Langella, Michele Casella, Roberto Lo Tesoriere, Alessandro Ferrero, have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Russolillo, N., Borello, A., Langella, S. et al. Comparison of laparoscopic ultrasound and liver-specific magnetic resonance imaging for staging colorectal liver metastases. Surg Endosc 35, 3547–3553 (2021). https://doi.org/10.1007/s00464-020-07817-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-020-07817-9

Keywords

Search

Navigation