Detection of Hypovascular Hepatic Metastases at Triple-Phase Helical CT: Sensitivity of Phases and Comparison with Surgical and Histopathologic Findings

Soyer, Philippe; Poccard, Marc; Boudiaf, Mourad; Abitbol, Martine; Hamzi, Lounis; Panís, Yves; Valleur, Patrice; Rymer, R

doi:10.1148/radiol.2312021639

Cited by 127 publications

(56 citation statements)

References 19 publications

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“…A review of the literature indicates that MRI is more sensitive than CT for subcentimetre liver lesions [21] and after neoadjuvant chemotherapy [22], and that a thoraco-abdominal CT is the best option for initial staging [12]. Appraisal of published methods shows that a quadri/triphasic technique, optimal contrast administration and scanning parameters providing high spatial and contrast resolution show superior CT accuracy than generally reported in the literature [23][24][25]22]. Regardless of the technique, the need for high-quality baseline imaging before any chemotherapy cannot be stressed enough.…”

Section: The Role Of Imaging In the Detection Of Synchronous Crclmmentioning

confidence: 99%

Managing synchronous liver metastases from colorectal cancer: A multidisciplinary international consensus

Adam

Gramont

Figueras

et al. 2015

Cancer Treatment Reviews

469

413

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a b s t r a c tAn international panel of multidisciplinary experts convened to develop recommendations for managing patients with colorectal cancer (CRC) and synchronous liver metastases (CRCLM). A modified Delphi method was used. CRCLM is defined as liver metastases detected at or before diagnosis of the primary CRC. Early and late metachronous metastases are defined as those detected 612 months and >12 months after surgery, respectively. To provide information on potential curability, use of high-quality contrast-enhanced computed tomography (CT) before chemotherapy is recommended. Magnetic resonance imaging is increasingly being used preoperatively to aid detection of subcentimetric metastases, Contents lists available at ScienceDirectCancer Treatment Reviews j o u r n a l h o m e p a g e : w w w . e l s e v i e r h e a l t h . c o m / j o u r n a l s / c t r v and alongside CT in difficult situations. To evaluate operability, radiology should provide information on: nodule size and number, segmental localization and relationship with major vessels, response after neoadjuvant chemotherapy, non-tumoral liver condition and anticipated remnant liver volume. Pathological evaluation should assess response to preoperative chemotherapy for both the primary tumour and metastases, and provide information on the tumour, margin size and micrometastases. Although the treatment strategy depends on the clinical scenario, the consensus was for chemotherapy before surgery in most cases. When the primary CRC is asymptomatic, liver surgery may be performed first (reverse approach). When CRCLM are unresectable, the goal of preoperative chemotherapy is to downsize tumours to allow resection. Hepatic resection should not be denied to patients with stable disease after optimal chemotherapy, provided an adequate liver remnant with inflow and outflow preservation remains. All patients with synchronous CRCLM should be evaluated by a hepatobiliary multidisciplinary team.

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Section: The Role Of Imaging In the Detection Of Synchronous Crclmmentioning

confidence: 99%

Managing synchronous liver metastases from colorectal cancer: A multidisciplinary international consensus

Adam

Gramont

Figueras

et al. 2015

Cancer Treatment Reviews

469

413

View full text Add to dashboard Cite

show abstract

“…In this article, we review the management of mCRC, including the role of imaging in each treatment strategy, with emphasis on contemporary chemotherapeutic regimens and new molecular targeted therapies (MTTs). intravenous contrast material administration), with a detection rate of 85% and a positive predictive value of 96% (16). In the arterial phase, CRC metastases can have peripheral rimlike enhancement.…”

Section: Multidetector Ctmentioning

confidence: 99%

Update on the Role of Imaging in Management of Metastatic Colorectal Cancer

Tirumani¹,

Kim²,

Nishino³

et al. 2014

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“…If the presence of micrometastases around a CRLM could be related to the cytoreduction after some type chemotherapy has to be clarified yet. The rate of cut edge recurrence is reported to be up to 13.3% for a margin inferior to 2 mm, but if the surgical margin could represents a prognostic factor for patients survival is still debated [48,49]. Anyway, all the authors agree that micrometastases are confined to a short distance from the tumour (mostly less than 5-10 mm) and that a tumour margin of 10 mm is safe without risk of cut-edge recurrence.…”

Section: Echo-guided Liver Resectionmentioning

confidence: 99%

The Role of Ultrasound in Hepatic Surgery

Garancini¹,

Gianotti²,

Romano³

et al. 2013

Hepatic Surgery

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Detection of Hypovascular Hepatic Metastases at Triple-Phase Helical CT: Sensitivity of Phases and Comparison with Surgical and Histopathologic Findings

Abstract: Preoperative use of triple-phase helical CT in patients with hypovascular hepatic metastases may not be warranted. Portal-dominant phase helical CT imaging allows depiction of significantly more hypovascular hepatic metastases than does imaging during any of the other phases.

Cited by 127 publications

References 19 publications

Managing synchronous liver metastases from colorectal cancer: A multidisciplinary international consensus

Managing synchronous liver metastases from colorectal cancer: A multidisciplinary international consensus

Update on the Role of Imaging in Management of Metastatic Colorectal Cancer

The Role of Ultrasound in Hepatic Surgery

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