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
StatePublished - Sep 1 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

  • Radiology Nuclear Medicine and imaging

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