US or CT when it Comes to Monitoring Hepatic Metastases in Patients with Primary GIT and Breast Cancer? Comparative Results of Sensitivity and Specificity of CT and US

Abstract

Malignant diseases are one of the greatest health challenges at the global level and a major social, public health and economic problem in the 21st century with the three most common types of cancer: lung cancer, breast cancer and colorectal cancer. Radiodiagnostics plays a major role in detecting the primary disease, its stage, the presence or absence of secondary deposits, response to therapy, and monitoring for possible relapses. The current challenge for radiodiagnostic methods is to provide aaccurate, non-invasive method that is highly sensitive and specific and well-tolerated by the patient. We conducted a prospective comparative study over a period of 12 months, which included 82 subjects, patients with metastatic liver disease with primary gastrointestinal tract cancer and breast cancer. Two CT contrast examinations were performed in three phases, as well as four US examinations over a period of 3 months, both examinations within 12 months.The aim of the study was to determine the sensitivity and specificity of ultrasound in relation to all phases of CT taken as the gold standard for detection of hepatic metastases. From the results obtained, US showed the highest sensitivity (100%) and specificity (92.31%) in patients with GIT cancer in hyperechoic changes compared to the arterial phase of CT, while in patients with breast cancer, the sensitivity of US is highest in ring changes (85.71%), and the specificity in isoechoic changes (95%). Regarding the venous phase, US did not show sensitivity for the detection of hepatic lesions in patients with cancer originating from the GIT, while in patients with breast cancer it showed maximum sensitivity (100%) in the detection of ring lesions, and maximum specificity for hypoechoic lesions (100%). US was shown to be sensitive compared to late-phase CT in detecting isoechoic changes in patients with breast cancer (83.33%), but insufficiently sensitive for changes in patients with GIT cancer. The specificity of US is maximum for hypoechoic changes in patients with GIT cancer (100%), and isoechoic changes in patients with breast cancer (88.57%)