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Title: Hepatic metastases from colorectal cancer: preoperative detectiona and assessment of resectability with helical CT
Author: Valls Duran, Carlos
Andía, Eduard
Sánchez, Anna
Gumà i Garcia, Anna Maria
Figueras Felip, Joan
Torras, Jaume
Serrano Piñol, M. Teresa
Keywords: Càncer colorectal
Diagnòstic per la imatge
Càncer de fetge
Colorectal cancer
Diagnostic imaging
Liver cancer
Issue Date: 1-Jan-2001
Publisher: Radiological Society of North America.
Abstract: Purpose: to prospectively evaluate helical computed tomography (CT) in the preoperative detection of hepatic metastases and assessment of resectability with surgical, intraoperative ultrasonographic (US), and histopathologic correlation. Materials and methods: between October 1995 and December 1998, preoperative staging with helical CT (5-mm collimation; reconstruction interval, 5 mm) was performed in 157 patients with hepatic metastases. Iodinated contrast material was injected intravenously (160-170 mL; rate, 2.5-3.0 mL/sec); acquisition began at 60-70 seconds. Four radiologists prospectively assessed the metastatic involvement of the liver by indicating the number and location of the lesions; resection was indicated in 113 patients (119 instances). Helical CT findings were correlated with pathologic and surgical findings on a lesion-by-lesion basis. Results: intraoperative US, palpation, and histopathologic examination revealed 290 liver metastases; helical CT correctly depicted 247. Helical CT results were the following: overall detection rate, 85.1% (95% CI: 80.8%, 89.3%); positive predictive value, 96.1% (95% CI: 92.9%, 98.1%); and false-positive rate, 3.9% (10 of 257 findings; 95% CI: 1.9%, 7.1%). False-positive findings were related to hemangioendothelioma, hemangioma, hepatic peliosis, biliary adenoma, centrilobar hemorrhage, biliary hamartoma, periportal fibrosis, and normal liver parenchyma. Curative resection was performed in 112 instances with a resectability rate of 94.1%. Four-year patient survival rate was 58.6%. Conclusion: helical CT is a noninvasive, reliable, and accurate technique for imaging the liver and should be considered as the standard preoperative work-up of hepatic metastases from colorectal cancer.
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It is part of: Radiology, 2001, vol. 218, num. 1, p. 55-60
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ISSN: 0033-8419
Appears in Collections:Articles publicats en revistes (Patologia i Terapèutica Experimental)
Articles publicats en revistes (Ciències Clíniques)

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