Evidence map›Paper›PMID 34159555›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2021

Intraoperative (Contrast-Enhanced) Ultrasound Has the Highest Diagnostic Accuracy of Any Imaging Modality in Resection of Colorectal Liver Metastases.

Gregor A Stavrou, Axel Stang, Dimitri A Raptis, Erik Schadde, Martin Zeile, Roland Brüning, Kim C Wagner, Tessa M Huber, Karl J Oldhafer

Registry-linked trialAbstract read
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In one paragraph

Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01522209 (Value of Contrast Enhanced Intraoperative Ultrasound Compared to Preoperative CEUS, CT and MRT in the Treatment of Colorectal Liver Metastases.), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01522209 nacompletednot on this map

Value of Contrast Enhanced Intraoperative Ultrasound Compared to Preoperative CEUS, CT and MRT in the Treatment of Colorectal Liver Metastases.

TypeinterventionalSponsorAsklepios Kliniken Hamburg GmbHRan2011 to 2015Enrolled59ConditionsColon Cancer Liver Metastasis, Contrast Enhances Intraoperative Ultrasound, Imaging for Liver Cancer, Imaging for Liver MetastasisArmsLiver Surgery, Contrast Enhanced Ultrasound, CT Scan (standard), Primovist MRI (3 Tesla)
3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
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  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Gregor A StavrouDepartment of General, Visceral and Thoracic Surgery, Surgical Oncology, Klinikum Saarbruecken General Hospital, Saarbruecken, Germany. stavrou@liversurgery.de.ORCID 0000-0002-6890-4271
Axel StangSemmelweis Medical Faculty, Asklepios Campus Hamburg, Hamburg, Germany.
Dimitri A RaptisDepartment of Surgery and Liver Transplantation, Royal Free Hospital, London, UK.
Erik SchaddeDepartment of Surgery, Division of Surgical Oncology and Division of Transplant Surgery, Rush University Medical Center, Chicago, IL, USA.
Martin ZeileDepartment of Radiology, Marienkrankenhaus Hamburg, Hamburg, Germany.
Roland BrüningDepartment of Radiology, Asklepios Hospital Barmbek, Hamburg, Germany.
Kim C WagnerDepartment of General and Visceral Surgery, Surgical Oncology, Asklepios Hospital Barmbek, Hamburg, Germany.
Tessa M HuberDepartment of General and Visceral Surgery, Surgical Oncology, Asklepios Hospital Barmbek, Hamburg, Germany.
Karl J OldhaferSemmelweis Medical Faculty, Asklepios Campus Hamburg, Hamburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimDefining sensitivity, specificity, diagnostic accuracy for detection of colorectal liver metastases in imaging compared to intraoperative assessment. Defining a cutoff, where accuracy of detection is impaired.

methodsProspective single-institution clinical trial (clinicaltrials.gov: NCT01522209). Patients underwent CEUS, MDCT, and 3 Tesla EOB-MRI within 2 weeks preoperatively. Intraoperative palpation, IOUS, and CEIOUS were performed. A patient and lesion-based database was analyzed for accuracy of detection of CEUS, CT, MRI, and Palp/IOUS/CEIOUS combined read. Histology was standard of reference.

resultsForty-seven high tumor load (mean 5, 4 lesions) patients were analyzed. Histopathology confirmed 264 lesions (245 malignant: 19 benign). Accuracy for detection of all lesions: CEUS 63%, CT 71%, MRI 92%, and PALP/IOUS/CEIOUS 98%. ROC analysis for lesion size showed severe impairment of accuracy in lesion detection smaller than 5mm. Intraoperative imaging was not impaired by lesion size. Patient-based analysis revealed a change of resection plan after IOUS/CEIOUS in 35% of patients.

conclusionAt 5-mm lesion size, preoperative imaging shows a drop in accuracy of detection. In patients with multiple lesions, addition of MRI to MDCT seems useful. Accuracy of intraoperative ultrasound is not impacted by lesion size and should be mandatory. CEIOUS can improve intraoperative decision-making.

trial registrationStudy registered with clinicaltrials.gov : NCT01522209.

Indexed as

Colorectal NeoplasmsLiver NeoplasmsContrast MediaHepatectomyHumansMagnetic Resonance ImagingProspective StudiesUltrasonographyContrast MediaAccuracyCEIOUSColorectalImagingIOUSLiver metastasisSensitivitySpecificity

Identifiers

PMID34159555

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.