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3D image guidance assisted identification of colorectal cancer liver metastases not seen on intraoperative ultrasound: results from a prospective trial.

Publication ,  Journal Article
Kingham, TP; Pak, LM; Simpson, AL; Leung, U; Doussot, A; D'Angelica, MI; DeMatteo, RP; Allen, PJ; Jarnagin, WR
Published in: HPB (Oxford)
March 2018

BACKGROUND: Neoadjuvant treatment of colorectal liver metastases has become increasingly common, and while effective, often renders small metastases difficult to visualize on intraoperative US. The objective of this study was to determine the utility of a 3D image-guidance system in patients with intraoperative sonographically-occult CRLM. METHODS: 50 patients with at least one CRLM ≤ 1.5 cm were enrolled in this prospective trial of an FDA-approved Explorer image-guidance system. If the tumor(s) seen on preoperative imaging were not identified with intraoperative US, Explorer was used to target the US examination to the involved area for a more focused assessment. The primary endpoint was the proportion of cases with sonographically-occult metastases identified using Explorer. RESULTS: Forty-eight patients with preoperative scans within eight weeks of surgery were included for analysis. Forty-six patients were treated with preoperative chemotherapy (median 4 months, range 2-24 months). Overall, 22 sonographically-occult tumors in 14 patients were interrogated by Explorer, of which 15 tumors in 10 patients were located with image-guidance assistance. The only difference between patients with tumors not identified on US and those who did was the number of tumors (median 3 vs. 2, p = 0.018). CONCLUSION: 3D image-guidance can assist in identifying small CRLM, particularly after treatment with chemotherapy. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02806037, https://clinicaltrials.gov/ct2/show/NCT02806037.

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Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

March 2018

Volume

20

Issue

3

Start / End Page

260 / 267

Location

England

Related Subject Headings

  • Ultrasonography
  • Tumor Burden
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Time Factors
  • Surgery, Computer-Assisted
  • Surgery
  • Prospective Studies
  • Predictive Value of Tests
  • Patient-Specific Modeling
 

Citation

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Kingham, T. P., Pak, L. M., Simpson, A. L., Leung, U., Doussot, A., D’Angelica, M. I., … Jarnagin, W. R. (2018). 3D image guidance assisted identification of colorectal cancer liver metastases not seen on intraoperative ultrasound: results from a prospective trial. HPB (Oxford), 20(3), 260–267. https://doi.org/10.1016/j.hpb.2017.08.035
Kingham, T Peter, Linda M. Pak, Amber L. Simpson, Universe Leung, Alexandre Doussot, Michael I. D’Angelica, Ronald P. DeMatteo, Peter J. Allen, and William R. Jarnagin. “3D image guidance assisted identification of colorectal cancer liver metastases not seen on intraoperative ultrasound: results from a prospective trial.HPB (Oxford) 20, no. 3 (March 2018): 260–67. https://doi.org/10.1016/j.hpb.2017.08.035.
Kingham TP, Pak LM, Simpson AL, Leung U, Doussot A, D’Angelica MI, et al. 3D image guidance assisted identification of colorectal cancer liver metastases not seen on intraoperative ultrasound: results from a prospective trial. HPB (Oxford). 2018 Mar;20(3):260–7.
Kingham, T. Peter, et al. “3D image guidance assisted identification of colorectal cancer liver metastases not seen on intraoperative ultrasound: results from a prospective trial.HPB (Oxford), vol. 20, no. 3, Mar. 2018, pp. 260–67. Pubmed, doi:10.1016/j.hpb.2017.08.035.
Kingham TP, Pak LM, Simpson AL, Leung U, Doussot A, D’Angelica MI, DeMatteo RP, Allen PJ, Jarnagin WR. 3D image guidance assisted identification of colorectal cancer liver metastases not seen on intraoperative ultrasound: results from a prospective trial. HPB (Oxford). 2018 Mar;20(3):260–267.
Journal cover image

Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

March 2018

Volume

20

Issue

3

Start / End Page

260 / 267

Location

England

Related Subject Headings

  • Ultrasonography
  • Tumor Burden
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Time Factors
  • Surgery, Computer-Assisted
  • Surgery
  • Prospective Studies
  • Predictive Value of Tests
  • Patient-Specific Modeling