The objective of the present study was to compare conventional B-mode ultrasound (BMU), contrast-enhanced ultrasound (CEUS), and magnetic resonance imaging (MRI) in the detection of liver metastases at the primary staging and follow-up of women with histologically confirmed mammary carcinoma.
Patients and methods
Included in the study were 55 women (aged 57.5±11.0 years, range 27–75 years; mean disease duration 57.5 months, range 5–168 months); of these, 17 women were examined as part of primary staging (staging group) and 38 women at follow-up (follow-up group). All patients underwent BMU (Philips HDI 5000), CEUS (Philips HDI 5000; 4.8 ml SonoVue), and MRI (Siemens Avanto 1.5 T) of the liver.
In the staging group (n=17), a mass was detected by BMU in 24% (n=4), by CEUS in 29% (n=5), and by MRI in 47% (n=8); masses suspicious for malignancy were identified in 6% of patients with BMU and in 12% each by CEUS and MRI. Malignancy was not confirmed in any case by cytology or surgery. In the follow-up group (n=38), masses were identified by MRI in 53% of patients with suspicion of malignancy in 18%. Malignancy was confirmed in 16% of cases identified at MRI, in 13% of cases identified with CEUS, and in 11% of cases identified with BMU. The Pearson coefficients of correlation were r=.29 (P=.03) for MRI vs. BMU; r=.42 (P=.002) for MRI vs. CEUS; and r=.75 (P≤.001) for BMU vs. CEUS. With respect to malignancy, the Pearson coefficients of correlation were r=.40 (P=.099) for BMU vs. MRI and r=.71 (P=.0009) for CEUS vs. MRI.
Beginning in tumor stage III, the use of CEUS and MRI is associated with a significantly greater benefit in the detection of malignant tumors of the liver compared with conventional BMU. BMU appears to be adequate for primary staging and the follow-up of lower tumor stages.
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- Metastatic breast cancer. Recommendations proposal from the European School of Oncology (ESO)-MBC Task Force.Breast. 2007; 16: 9-10
- Staging of breast cancer: new recommended standard procedure.Breast Cancer Res Treat. 2002; 72: 53-60
- Baseline staging tests after a new diagnosis of breast cancer: further evidence of their limited indications.Ann Oncol. 2005; 16: 263-266
- Baseline staging tests in primary breast cancer: a practice guideline.CMAJ. 2001; 164: 1439-1444
- Assessment of metastatic liver disease in patients with primary extrahepatic tumors by contrast-enhanced sonography versus CT and MRI.World J Gastroenterol. 2006; 12: 1699-1705
- Liver metastases in cancer: detection with contrast-enhanced ultrasonography.Abdom Imaging. 2004; 29: 669-681
- Characterization of focal liver lesions: comparative study of contrast-enhanced ultrasound versus spiral computed tomography.Eur Radiol. 2007; 17: 1066-1073
- Focal liver lesions: can SonoVue-enhanced ultrasound be used to differentiate malignant from benign lesions?.Invest Radiol. 2007; 42: 596-603
- Benefits of contrast-enhanced sonography for the detection of liver lesions: comparison with histologic findings.AJR Am J Roentgenol. 2008; 190: 683-690
- Evaluation of malignant liver tumors: biphasic MS-CT versus quantitative contrast harmonic imaging ultrasound.Z Gastroenterol. 2009; 47: 1195-1202
- Imaging of focal liver lesions: low-mechanical-index real-time ultrasonography with SonoVue.J Ultrasound Med. 2005; 24: 285-297
- The role of real-time contrast-enhanced and real-time virtual sonography in the assessment of malignant liver lesions.J Gastrointestin Liver Dis. 2009; 18: 103-108
- Hepatic resection for breast cancer metastases.Ann R Coll Surg Engl. 2005; 87: 167-170
- Liver resection for multimodal treatment of breast cancer metastases: identification of prognostic factors.Ann Surg Oncol. 2010; 17: 1546-1554
- Hepatic resection for liver metastases as part of the “oncosurgical” treatment of metastatic breast cancer.Ann Surg Oncol. 2008; 15: 2804-2810
- Liver resection for breast cancer metastasis: does it improve survival?.Surg Today. 2008; 38: 293-299
- Changes in indication and results after resection of hepatic metastases from noncolorectal primary tumors: a single-institutional review.Ann Surg Oncol. 2005; 12: 778-785
- Is liver resection justified for patients with hepatic metastases from breast cancer?.Ann Surg. 2006; 244: 897-907
- Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1,452 patients and development of a prognostic model.Ann Surg. 2006; 244: 524-535
- The 2003 revised TNM staging system for breast cancer: results of stage re-classification on survival and future comparisons among stage groups.Ann Surg Oncol. 2007; 14: 143-147
- Regulated hepatectomies: excision of the lateral segment of the right liver.J Chir (Paris). 1955; 71: 578-603
- Ultrasound scanning in the detection of hepatic fibrosis and steatosis.Br Med J (Clin Res Ed). 1986; 292: 13-15
- The severity of ultrasonographic findings in nonalcoholic fatty liver disease reflects the metabolic syndrome and visceral fat accumulation.Am J Gastroenterol. 2007; 102: 2708-2715
Charatcharoenwitthaya P, Lindor KD. Role of radiologic modalities in the management of non-alcoholic steatohepatitis. Clin Liver Dis 2007;11:37-54, vii.
- Factors affecting liver size: a sonographic survey of 2080 subjects.J Ultrasound Med. 2003; 22: 1155-1161
- Comparison of panorama ultrasonography, conventional B-mode ultrasonography, and computed tomography for measuring liver size.Ultraschall Med. 2010; 31: 31-36
- Measuring agreement in method comparison studies.Stat Methods Med Res. 1999; 8: 135-160
- Baseline staging of newly diagnosed breast cancer—Kuwait cancer control center experience.Med Princ Pract. 2007; 16: 22-24
- Radiologic tests after a new diagnosis of breast cancer.Eff Clin Pract. 2000; 3: 1-6
- A perioperative screening for metastatic disease is not indicated in patients with primary breast cancer and no clinical signs of tumor spread.Zentralbl Gynakol. 2004; 126: 275-279
- Bone scan and liver ultrasound scan in the preoperative staging for primary breast cancer.Breast J. 2006; 12: 544-548
- Focal liver lesions: contrast-enhanced ultrasound.Abdom Imaging. 2009; 34: 193-209
- Contrast-enhanced ultrasonography in diagnosing liver metastases.Med Sci Monit. 2007; 13: 111-115
- Baseline and contrast-enhanced ultrasound of the liver in tumor patients.Ultraschall Med. 2008; 29: 488-498
- Comparison of contrast-enhanced ultrasonography versus baseline ultrasound and contrast-enhanced computed tomography in metastatic disease of the liver: diagnostic performance and confidence.Eur Radiol. 2006; 16: 1599-1609
- The value of contrast enhanced ultrasonography in detection of liver metastases from colorectal cancer: a prospective double-blinded study.Eur J Radiol. 2007; 62: 302-307
- Survival of metastatic breast carcinoma patients over a 20-year period: a retrospective analysis based on individual patient data from six consecutive studies.Cancer. 2005; 104: 1742-1750
- Real-time contrast-enhanced ultrasound in the evaluation of focal liver lesions: diagnostic efficacy and economical issues from a French multicentric study.J Radiol. 2009; 90: 109-122
- Contrast-enhanced ultrasound for the characterization of focal liver lesions—diagnostic accuracy in clinical practice (DEGUM multicenter trial).Ultraschall Med. 2008; 29: 499-505
- Haemodynamic parameters of the hepatic artery and vein can detect liver metastases: assessment using contrast-enhanced ultrasound.Br J Radiol. 2008; 81: 113-119
- Contrast-enhanced ultrasonography in the follow-up of patients with hepatic metastases from breast carcinoma.Radiol Med. 2007; 112: 47-55
- Clinical characteristics and potential prognostic factors of breast cancer patients with liver metastases.Zhonghua Zhong Liu Za Zhi. 2006; 28: 612-616
- Economic assessment of contrast-enhanced ultrasonography for evaluation of focal liver lesions: a multicentre Italian experience.Eur Radiol. 2007; 17: F99-F106
Published online: November 15, 2010
Accepted: September 2, 2010
Received: July 15, 2010
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.