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CT Laparoscopy for Detecting Small Superficial Metastatic Lesions of the Liver Surface: Initial Experience

¹ Department of Radiology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyoku, Kyoto 606-8507, Japan.
² Division of Gastrointestinal Surgery, Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.

OBJECTIVE. The purpose of this study was to determine the efficacy of CT laparoscopy in the detection of superficial metastasis of the liver surface.

SUBJECTS AND METHODS. From April 1, 2007, to July 1, 2007, a total of 34 consecutively registered patients (19 men, 15 women; median age, 55 years) with various intraabdominal malignant tumors underwent preoperative CT and composed the study population. All patients underwent superparamagnetic iron oxide–enhanced MRI and portal phase contrast-enhanced 64-MDCT, including CT laparoscopy. CT laparoscopy is a form of volume-rendering 3D imaging of the liver that depicts the liver surface in detail.

RESULTS. Among 23 patients who underwent surgery for management of a primary tumor, four patients had seven superficial metastatic lesions of the liver surface. None of these lesions had been detected with preoperative axial CT or superparamagnetic iron oxide–enhanced MRI. In contrast, CT laparoscopy revealed four of seven lesions in four patients. On a lesion-by-lesion basis, the sensitivity was 57%, the positive predictive value was 100%, and the accuracy was 57%.

CONCLUSION. Our initial experience proves that CT laparoscopy is a promising method for detecting small superficial metastatic lesions of the liver surface. The findings can influence decisions regarding tumor resectability.

Keywords: 64-MDCT • CT laparoscopy • liver surface • superficial liver metastasis • volume rendering

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