Contrast-enhanced ultrasonography in the follow-up of patients with hepatic metastases from breast carcinoma

PURPOSE: Oncological treatment planning relies on the evaluation of treatment response, which is defined by the change in size of measurable lesions. The purpose of this study was to evaluate the use of contrast-enhanced ultrasound (CEUS) to obtain a precise measurement of hepatic metastases in breast cancer patients with fatty-liver disease. MATERIALS AND METHODS: Twelve consecutive patients with 25 liver metastases from breast cancer and fatty liver disease, as defined by US criteria, were enrolled in this prospective study. All patients underwent conventional US, CEUS and multidetector computed tomography (MDCT), used as the gold standard for measuring the maximum diameter of lesions. Agreement between US, CEUS and MDCT measurements was analysed using Altman-Bland plots; 95% confidence limits were calculated for the difference among means. RESULTS: Mean diameter as measured by MDCT was 26.2 mm (range 11-83). US allowed measurement of 20/25 lesions. In 15 lesions, CEUS measurements were more accurate than those obtained by US. The difference among means was 1.1 mm with a 95% confidence interval (-9.2, 11.4) for US measurements and 0.6 mm with a 95% confidence interval (-2.0, 3.1) for CEUS. CONCLUSIONS: Our preliminary data show that CEUS can be used to obtain more accurate measurements than conventional US for the follow-up of patients with metastases in fatty liver.