CT laparoscopy for detecting small superficial metastatic lesions of the liver surface: initial experience

AJR Am J Roentgenol. 2008 May;190(5):1314-7. doi: 10.2214/AJR.07.2887.

Abstract

Objective: The purpose of this study was to determine the efficacy of CT laparoscopy in the detection of superficial metastasis of the liver surface.

Subjects and methods: From April 1, 2007, to July 1, 2007, a total of 34 consecutively registered patients (19 men, 15 women; median age, 55 years) with various intraabdominal malignant tumors underwent preoperative CT and composed the study population. All patients underwent superparamagnetic iron oxide-enhanced MRI and portal phase contrast-enhanced 64-MDCT, including CT laparoscopy. CT laparoscopy is a form of volume-rendering 3D imaging of the liver that depicts the liver surface in detail.

Results: Among 23 patients who underwent surgery for management of a primary tumor, four patients had seven superficial metastatic lesions of the liver surface. None of these lesions had been detected with preoperative axial CT or superparamagnetic iron oxide-enhanced MRI. In contrast, CT laparoscopy revealed four of seven lesions in four patients. On a lesion-by-lesion basis, the sensitivity was 57%, the positive predictive value was 100%, and the accuracy was 57%.

Conclusion: Our initial experience proves that CT laparoscopy is a promising method for detecting small superficial metastatic lesions of the liver surface. The findings can influence decisions regarding tumor resectability.

MeSH terms

  • Aged
  • Contrast Media
  • Digestive System Neoplasms / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Iopamidol / analogs & derivatives
  • Laparoscopy*
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / surgery
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Tomography, X-Ray Computed*

Substances

  • Contrast Media
  • iomeprol
  • Iopamidol