Ultraschall Med 2007; 28 - V_5_25
DOI: 10.1055/s-2007-988991

Adrenocortical cancer: Improved detection of hepatic metastases with contrast-enhanced ultrasound as compared to contrast-enhanced CT

J Bauditz 1, M Quinckler 1, D Beyersdorff 2, W Wermke 1
  • 1Charité, IV. Med. Klinik, Berlin, Germany
  • 2Charité, Radiologie, Berlin, Germany

Objective: Adrenocortical carcinoma (ACC) is a rare malignancy. Computerized tomography (CT) and magnetic resonance imaging (MRI) are routinely performed for staging. Contrast ultrasound has been shown to have a high sensitivity and specifity for differentiation of hepatic and neuroendocrine tumours.

Methods: 12 patients (7 women, 5 men; aged 24 to 77 years) with ACC were treated in our centre from 2004 to 2006. Patients received staging with contrast-enhanced multislice spiral computed tomography (MSCT) as well as standard B-mode sonography and contrast-enhanced ultrasound (SonoVue/Bracco, Siemens Acuson Sequoia 512; low-MI/CPS).

Results: Contrast ultrasound demonstrated liver metastases in 8 of 12 patients (67%), MSCT showed liver metastases in 6 of 12 patients (50%). In 2 of 8 patients (25%) MSCT missed detection of liver metastases. Even in retrospective analysis with knowledge of the ultrasound results, the hepatic lesions were not recognized by MSCT, but were detectable by MSCT at a later time point. All hepatic lesions diagnosed by MSCT were also seen by ultrasound. The detection of liver metastases by ultrasound resulted in a change of therapy in the 2 patients.

Conclusions: Contrast ultrasound has a higher sensitivity than MSCT in detecting highly vascularized liver metastases of adrenocortical carcinoma and should be included in the staging algorithm of ACC.