Screening for liver metastases in women with mammary carcinoma: comparison of contrast-enhanced ultrasound and magnetic resonance imaging

Objective

The objective of the present study was to compare conventional B-mode ultrasound (BMU), contrast-enhanced ultrasound (CEUS), and magnetic resonance imaging (MRI) in the detection of liver metastases at the primary staging and follow-up of women with histologically confirmed mammary carcinoma.

Patients and methods

Included in the study were 55 women (aged 57.5±11.0 years, range 27-75 years; mean disease duration 57.5 months, range 5-168 months); of these, 17 women were examined as part of primary staging (staging group) and 38 women at follow-up (follow-up group). All patients underwent BMU (Philips HDI 5000), CEUS (Philips HDI 5000; 4.8 ml SonoVue), and MRI (Siemens Avanto 1.5 T) of the liver.

Results

In the staging group (n=17), a mass was detected by BMU in 24% (n=4), by CEUS in 29% (n=5), and by MRI in 47% (n=8); masses suspicious for malignancy were identified in 6% of patients with BMU and in 12% each by CEUS and MRI. Malignancy was not confirmed in any case by cytology or surgery. In the follow-up group (n=38), masses were identified by MRI in 53% of patients with suspicion of malignancy in 18%. Malignancy was confirmed in 16% of cases identified at MRI, in 13% of cases identified with CEUS, and in 11% of cases identified with BMU. The Pearson coefficients of correlation were r=.29 (P=.03) for MRI vs. BMU; r=.42 (P=.002) for MRI vs. CEUS; and r=.75 (P≤.001) for BMU vs. CEUS. With respect to malignancy, the Pearson coefficients of correlation were r=.40 (P=.099) for BMU vs. MRI and r=.71 (P=.0009) for CEUS vs. MRI.

Conclusions

Beginning in tumor stage III, the use of CEUS and MRI is associated with a significantly greater benefit in the detection of malignant tumors of the liver compared with conventional BMU. BMU appears to be adequate for primary staging and the follow-up of lower tumor stages.