High resolution – sonography in the diagnosis of liver metastases

Objective: High frequency ultrasound transducers have been helpful in certain settings of transabdominal ultrasound examinations, however their value in the diagnosis of metastatic liver disease has not yet been analyzed.

The aim of this study was to evaluate the benefit of the additional use of a high-frequency ultrasound probe in finding additional suspicious liver lesions compared to the routine examination using a 3.5 MHz-transducer only.

Subjects and Methods: 157 patients with underlying malignant disease were examined with a 3.5 MHz- and a high frequency transducer (with or without tissue harmonic imaging) using one of three high-end ultrasound machines (Siemens Sonoline Elegra, GE Healthcare Logic 9, or Hitachi EUB–8500). Findings on hepatic lesions were collected on a standardized documentation sheet, and evaluated by descriptive statistics.

Results: Using the 3.5 MHz transducer, 64 patients (40.8% of all patients) had at least one liver lesion suspected to be malignant. In 29 patients (18.5%) new suspicious liver lesions were found by using the high frequency transducer. 13 of these were even thought to suffer from diffuse liver infiltration with malignant lesions or at least 10 additional visible metastases. On average, the high frequency ultrasound examination of the liver required 4 additional minutes (range one to 15 minutes).

Conclusion: This study demonstrates that the additional use of a high frequency transducer in patients with underlying malignant disease reveals new, potentially malignant hepatic lesions in almost every fifth patient. This high diagnostic yield is achieved by a short extension of the examination period.

Keywords: Lebermetastasen, Sonographie