Intraoperative US in patients undergoing surgery for liver neoplasms: Comparison with MR imaging

Dushyant V. Sahani, Sanjeeva P. Kalva, Kenneth K. Tanabe, Sikandar M. Hayat, Mary J. O'Neill, Elkan F. Halpern, Sanjay Saini, Peter R. Mueller

Research output: Contribution to journalArticle

95 Scopus citations


PURPOSE: To retrospectively compare intraoperative ultrasonography (US) and preoperative magnetic resonance (MR) imaging with contrast material enhancement for the depiction of liver lesions in patients undergoing hepatic resection. MATERIALS AND METHODS: A radiologist (D.V.S.) and a surgeon (K.K.T.) retrospectively identified 79 patients (36 female and 43 male patients; age range, 10-78 years; mean age, 57 years) who had undergone surgical resection for primary liver tumor or metastasis and had also undergone preoperative contrast-enhanced MR imaging within 6 weeks before surgery. MR imaging was performed with a 1.5-T system. Dedicated intraoperative US of the liver was performed or supervised by a gastrointestinal radiologist using a 7.5-MHz linear-array transducer, after adequate hepatic mobilization by the surgeon. Histopathologic evaluation of the 159 resected hepatic lesions served as the reference standard. The lesion distribution included colon cancer metastasis (n = 122), hepatocellular carcinoma (n = 23), cholangiocarcinoma (n = 6), cavernous hemangioma (n = 4), focal nodular hyperplasia (n = 2), hamartoma (n = 1), and metastatic embryonal sarcoma (n = 1). RESULTS: Of 159 lesions, 138 (86.7%) were identified at both MR imaging and intraoperative US. Twelve additional lesions (7.5%) in 10 patients were detected only at intraoperative US (eight metastases, one hepatocellular carcinoma, one cholangiocarcinoma, one hemangioma, and one biliary hamartoma). Both modalities failed to depict nine lesions (5.6%) (four metastases, four hepatocellular carcinomas, and one cholangiocarcinoma). The sensitivities of MR imaging and intraoperative US for liver lesion depiction were 86.7% and 94.3%, respectively. Surgical management was altered on the basis of the intraoperative US findings in only three of 10 patients (4%). CONCLUSION: Contrast-enhanced MR imaging is as sensitive as intraoperative US in depicting liver lesions before hepatic resection.

Original languageEnglish (US)
Pages (from-to)810-814
Number of pages5
Issue number3
Publication statusPublished - Sep 2004



  • Liver neoplasms
  • Liver neoplasms, MR
  • Liver neoplasms, US
  • Liver, surgery
  • Magnetic resonance (MR), comparative studies
  • Ultrasound (US), comparative studies
  • Ultrasound (US), intraoperative

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Sahani, D. V., Kalva, S. P., Tanabe, K. K., Hayat, S. M., O'Neill, M. J., Halpern, E. F., ... Mueller, P. R. (2004). Intraoperative US in patients undergoing surgery for liver neoplasms: Comparison with MR imaging. Radiology, 232(3), 810-814.