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

Purpose: To evaluate the use of contrast-enhanced ultrasound (CEUS) to obtain a precise measurement of hepatic metastases in breast cancer patients with fatty-liver. Materials and methods: Twelve consecutive patients with 25 liver metastases from breast cancer and fatty liver defined by ultrasound criteria were enrolled in this prospective study. All patients underwent conventional ultrasound (US), contrast enhanced ultrasound (CEUS) and Multidetector Computed Tomography (MDCT), used as gold standard for measuring the maximum diameter of lesions. Agreement between measures performed by US and CEUS with reference MDCT was analysed by Altman-Bland plots method. The 95% agreement limits were calculated for the mean difference. Results: Mean diameter measured by MDCT was 26.2 mm (range 11-83). US allowed to measure 20/25 lesions: 5 metastases were impossible to define. In 15 lesions the measure obtained by CEUS was more accurate than the one obtained by US. The mean difference to MDCT by CEUS is lower than by US and the differences between the means were 1.1 mm with 95% C.I. (-9.2, 11.4) for the measures by US and 0.6 mm with 95% C.I. (-2.0, 3.1) for the measures by CEUS. Conclusion: Our preliminary data show that CEUS should be used to obtain more accurate parameters than conventional US for follow-up of patients with metastases in fatty-liver.