DETECTION OF COLORECTAL LIVER METASTASES - COMPARISON OF LAPAROTOMY, CT, US, AND DOPPLER PERFUSION INDEX AND EVALUATION OF POSTOPERATIVE FOLLOW-UP RESULTS

PURPOSE: To assess the value of the Doppler perfusion index (DPI = the ratio of hepatic arterial to total liver blood flow) as measured with duplex and color Doppler sonography (DCDS) in comparison with compute d tomography (CT), conventional ultrasound (US), and laparotomy for th e detection of liver metastases in patients with colorectal cancer. MA TERIALS AND METHODS: DCDS measurement of the DPI and CT, US, and lapar otomy were performed in 161 consecutive colorectal cancer patients. Pa tients who underwent an apparently curative resection were followed up at 3-month intervals with US and at annual CT. RESULTS: Fifty-six pat ients had histologically proved liver metastases at initial examinatio n. Liver metastases were detected with DPI, CT, US, and laparotomy in 56, 45, 27, and 36 patients, respectively. After a 1-year follow-up, 2 3 patients had developed liver metastases, all of which were predicted on the basis of an abnormal DPI value. CONCLUSION: Results suggest th at DCDS measurement of the DPI is the most sensitive technique in dete ction of colorectal liver metastases. All studies should attempt to de fine normal liver on the basis of follow-up results rather than those of laparotomy.