The utility of laparoscopic ultrasound during minimally invasive liver procedures in patients with malignant liver tumors who have undergone preoperative magnetic resonance imaging

The management of patients with colorectal liver metastases (CRLM) has transformed over the past two decades. Advances in surgical techniques, systemic therapies and local treatments have resulted in a paradigm shift. Disease that would once have been considered terminal is now frequently treated aggressively with both a disease-free and overall survival benefit. In line with the expanding range of treatment options, there has been an increase in the volume and complexity of imaging required in the management of these patients to ensure optimal patient selection and outcome. The radiologist plays a pivotal role in interpreting these studies, conveying the relevant information and informing the discussion at multidisciplinary team meetings (MDM). The purpose of this review is to provide an update for radiologists on the current surgical management of patients with CRLM highlighting specific imaging information that is required by the MDT when assessing resectability and/or the need for additional liver-directed therapies.

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ICG guided surgery enhances liver tumor detection: a complementary tool for intraoperative ultrasonography – a case series study

Huerta,

Gómez-Gavara,

Martínez

et al. 2024

International Journal of Surgery Open

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Introduction: Indocyanine green (ICG) improves identification of liver tumors. The aim of the study is to determine the effectiveness of ICG fluorescence in detecting liver tumors when used in combination with preoperative MRI and intraoperative ultrasonography (IOUS). Methods: The study included patients who underwent minimally invasive liver resection for malignant tumors. All patients had a preoperative MRI and had ICG administered intravenously (0.2–0.5 mg/kg) 24 h before surgery. In theater, liver parenchyma was scanned with IOUS and ICG fluorescence. Tumors identified were resected and specimens sent for pathology assessment. Results: Sixty-two liver lesions were resected, out of which 42 were previously reported by MRI, 46 were detected by IOUS and 53 were identified by ICG. From 42 tumors detected by MRI, 34 were histologically consistent with cancer. By adding IOUS+ICG, 20 extra lesions were resected and 10 of them were malignant. Accuracy, sensitivity(S) and specificity(E) for malignant tumor detection for MRI, IOUS, and ICG was 70.9% (S 77.2%, E 55%), 74.1% (S 84%, E 50%), and 82.2% (S 97.7%, E 44%). Combination of ICG+IOUS showed the highest results when comparing the ROC curves. Conclusions: ICG is a high-performance adjunct to IOUS, improving intraoperative detection of extra lesions unseen on preoperative imaging.

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The utility of laparoscopic ultrasound during minimally invasive liver procedures in patients with malignant liver tumors who have undergone preoperative magnetic resonance imaging

Cited by 3 publications

References 23 publications

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ICG guided surgery enhances liver tumor detection: a complementary tool for intraoperative ultrasonography – a case series study

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