How Reliable Is Ultrasound for Detection and Follow Up on Breast Cancer Liver Metastases?
DOI:
https://doi.org/10.3889/oamjms.2025.11984Keywords:
breast cancer, computed tomography, liver metastases, ultrasoundAbstract
BACKGROUND: To find out whether and to what extent the two diagnostic methods are necessary – both the computed tomography and the ultrasound for diagnosis and staging at the same time on breast cancer liver metastases.
AIM: In order to protect patients from unnecessary CT ionizing radiation, we compared the level of agreement of two methods: ultrasound and computed tomography.
METHODS: We analyzed 41 patients with diagnosed breast cancer and synchronous liver metastases.
RESULTS: There is a poor level of agreement between the ultrasound and computed tomography in the arterial and portal phase in terms of showing hepatic metastases in primary breast cancers. The individual kappa values calculated for each category individually, show that the two methods agree best in detecting ring changes (0.573) and do not agree at all in detecting hyper lesions.
CONCLUSION: Only ultrasound is sufficient in the diagnosis and monitoring of annular hepatic metastases, because it best agrees with computed tomography in the arterial and venous phase, while computed tomography is the only method of choice for hyperechoic metastases. When it comes to hypoechoic metastases the computed tomography remains the gold standard for diagnosis in our institution.
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Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al.. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71: 209-49. https://doi.org/10.3322/caac.21660 PMid:33538338
Lourenço, C.; Conceição, F.; Jerónimo, C.; Lamghari, M.; Sousa, D.M. Stress in Metastatic Breast Cancer: To the Bone and Beyond. Cancers 2022, 14, 1881. https://doi.org/10.3390/cancers14081881 PMid:35454788 PMCid:PMC9028241
Bray, F.; Ferlay, J.; Soerjomataram, I.; Siegel, R.L.; Torre, L.A.; Jemal, A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2018, 68, 394-424. https://doi.org/10.3322/caac.21492 PMid:30207593
Wu, Q.; Li, J.; Zhu, S.; Wu, J.; Chen, C.; Liu, Q.; Wei, W.; Zhang, Y.; Sun, S. Breast cancer subtypes predict the preferential site of distant metastases: A SEER based study. Oncotarget 2017, 8, 27990-27996. https://doi.org/10.18632/oncotarget.15856 PMid:28427196 PMCid:PMC5438624
Buonomo, O.C.; Caredda, E.; Portarena, I.; Vanni, G.; Orlandi, A.; Bagni, C.; Petrella, G.; Palombi, L. New insights into the metastatic behavior after breast cancer surgery, according to well-established clinicopathological variables and molecular subtypes. PLoS ONE 2017, 12, e0184680. https://doi.org/10.1371/journal.pone.0184680 PMid:28922402 PMCid:PMC5602519
Almubarak, M.M.; Laé, M.; Cacheux, W.; de Cremoux, P.; Pierga, J.-Y.; Reyal, F.; Bennett, S.P.; Falcou, M.-C.; Salmon, R.J.; Baranger, B.; et al. Gastric metastasis of breast cancer: A single centre retrospective study. Dig. Liver Dis. 2011, 43, 823-827. https://doi.org/10.1016/j.dld.2011.04.009 PMid:21616731
Glover C, Douse P, Kane P, Karani J, Meire H, Mohammadtaghi S, Allen-Mersh TG. Accuracy of investigations for asymptomatic colorectal liver metastases. Dis Colon Rectum. 2002;45:476-484. https://doi.org/10.1007/s10350-004-6224-y PMid:12006929
Xu LH, Cai SJ, Cai GX, Peng WJ. Imaging diagnosis of colorectal liver metastases. World J Gastroenterol. 2011;17:4654-4659. https://doi.org/10.3748/wjg.v17.i42.4654 PMid:22180707 PMCid:PMC3237298
Cantisani V, Grazhdani H, Fioravanti C, Rosignuolo M, Calliada F, Messineo D, Bernieri MG, Redler A, Catalano C, D'Ambrosio F. Liver metastases: Contrast-enhanced ultrasound compared with computed tomography and magnetic resonance. World J Gastroenterol. 2014;20:9998-10007. https://doi.org/10.3748/wjg.v20.i29.9998 PMid:25110428 PMCid:PMC4123379
Matos AP, Altun E, Ramalho M, Velloni F, AlObaidy M, Semelka RC. An overview of imaging techniques for liver metastases management. Expert Rev Gastroenterol Hepatol. 2015;9:1561-1576. https://doi.org/10.1586/17474124.2015.1092873 PMid:26414180
Kulemann V, Schima W, Tamandl D, Kaczirek K, Gruenberger T, Wrba F, Weber M, Ba-Ssalamah A. Preoperative detection of colorectal liver metastases in fatty liver: MDCT or MRI? Eur J Radiol. 2011;79:e1-e6. https://doi.org/10.1016/j.ejrad.2010.03.004 PMid:20392584
Sahani DV, Bajwa MA, Andrabi Y, Bajpai S, Cusack JC. Current status of imaging and emerging techniques to evaluate liver metastases from colorectal carcinoma. Ann Surg. 2014;259:861-872. https://doi.org/10.1097/SLA.0000000000000525 PMid:24509207
Sica GT, Ji H, Ros PR. CT and MR imaging of hepatic metastases. AJR Am J Roentgenol. 2000;174:691-698. https://doi.org/10.2214/ajr.174.3.1740691 PMid:10701611
Matos AP, Altun E, Ramalho M, Velloni F, AlObaidy M, Semelka RC. An overview of imaging techniques for liver metastases management. Expert Rev Gastroenterol Hepatol. 2015;9:1561-1576. https://doi.org/10.1586/17474124.2015.1092873 PMid:26414180
Lincke T, Zech CJ. Liver metastases: Detection and staging. Eur J Radiol. 2017;97:76-82. https://doi.org/10.1016/j.ejrad.2017.10.016 PMid:29153371
Gore RM, Thakrar KH, Wenzke DR, Newmark GM, Mehta UK, Berlin JW. That liver lesion on MDCT in the oncology patient: is it important? Cancer Imaging. 2012;12:373-384. https://doi.org/10.1102/1470-7330.2012.9028 PMid:23023318 PMCid:PMC3485646
Kamaya A, Maturen KE, Tye GA, Liu YI, Parti NN, Desser TS. Hypervascular liver lesions. Semin Ultrasound CT MR. 2009;30:387-407. https://doi.org/10.1053/j.sult.2009.06.001 PMid:19842564
Bruneton JN, Balu-Maestro C, Raffaelli C, Mourou MY, Cambon P, Granon C. Indications for hepatic ultrasonography in breast cancer staging and follow-up. Breast Cancer Res Treat. 1996;37(2):115-21. https://doi.org/10.1007/BF01806493 PMid:8750579
Francis IR, Cohan RH, McNulty NJ, Platt JF, Korobkin M, Gebremariam A, Ragupathi KI. Multidetector CT of the liver and hepatic neoplasms: effect of multiphasic imaging on tumor conspicuity and vascular enhancement. AJR Am J Roentgenol. 2003 May;180(5):1217-24. doi: 10.2214/ajr.180.5.1801217. Erratum in: AJR Am J Roentgenol. 2003 Jul;181(1):283. https://doi.org/10.2214/ajr.180.5.1801217 PMid:12704026
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Copyright (c) 2025 Gabriela Dimova, Marija Karakolevska-Ilova, Antonio Gligorievski (Author)

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This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0)
