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Ultrasound Int Open 2017; 03(02): E60-E68
DOI: 10.1055/s-0043-100503
Review
© Georg Thieme Verlag KG Stuttgart · New York

Intraoperative Ultrasound as a Screening Modality for the Detection of Liver Metastases during Resection of Primary Colorectal Cancer - A Systematic Review

Signe Bremholm Ellebæk
1   Odense Universitets Hospital, Surgical Department A, Odense, Denmark
,
Claus Wilki Fristrup
1   Odense Universitets Hospital, Surgical Department A, Odense, Denmark
,
Michael Bau Mortensen
1   Odense Universitets Hospital, Surgical Department A, Odense, Denmark
› Author Affiliations
Further Information

Publication History

received 22 June 2016
revised 15 November 2016

accepted 18 December 2016

Publication Date:
07 June 2017 (online)

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Abstract

Colorectal cancer (CRC) is one of the most common cancer diseases worldwide. One in 4 patients with CRC will have a disseminated disease at the time of diagnosis and often in the form of synchronous liver metastases. Studies suggest that up to 30% of patients have non-recognized hepatic metastases during primary surgery for CRC. Intraoperative ultrasonography examination (IOUS) of the liver to detect liver metastases was considered the gold standard during open CRC surgery. Today laparoscopic surgery is the standard procedure, but laparoscopic ultrasound examination (LUS) is not performed routinely.

Aim To perform a systematic review of the test performance of IOUS and LUS regarding the detection of synchronous liver metastases in patients undergoing surgery for primary CRC.

Method The literature was systematically reviewed using the search engines: PubMed, Cochrane, Embase and Google. 21 studies were included in the review and the key words: intraoperative ultrasound, laparoscopic ultrasound, staging colon and rectum cancer.

Results Intraoperative ultrasound showed a higher sensitivity, specificity, positive predictive value and overall accuracy for the detection liver metastases during surgery for primary CRC, compared to preoperative imaging modalities (ultrasound, computed tomography (CT) and contrast-enhanced computed tomography (CE-CT)). LUS showed a higher detection rate for liver metastases compared to CT, CE-CT and magnetic resonance imaging (MRI).

Conclusion This systematic review found that both IOUS and LUS had a higher detection rate regarding liver metastases during primary CRC surgery, especially liver metastases<10 mm in diameter, when compared to US, CT, CE-CT and MRI.

Key words

surgery - metastases - abdomen - ultrasound - intraoperative
 

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