Comparative study of the diagnostic value of preoperative imaging studies vs. intraoperative diagnostic methods in patients with liver tumors

Objective: to compare the diagnostic value of preoperative imaging studies - ultrasonography and computed tomography (CT) vs. intraoperative diagnostic methods - inspection, palpation and intraoperative ultrasound (IOUS) in patients with primary and metastatic liver tumors.

Methods: the pre- and intraoperative diagnostics in 55 consecutive elective operations were compared.

Results: in 43 (80%) cases all of the diagnostic measures were completed, in 11 cases (20%) the IOUS was unnecessary because of widespread hepatic and/or extrahepatic disease diagnosed intraoperatively by inspection and/or palpation. The sensitivity of different methods compared with that of the triad of intraoperative inspection, palpation and IOUS were: preoperative ultrasonography - 57% (p=0,0013), CT - 69% (p=0,0012), intraoperative inspection and palpation - 78% (p=0,01), IOUS - 82% (p=0,01).

Conclusions: the diagnostic accuracy of preoperative imaging studies is still under the required criteria for the needs of surgical planning. The triad of intraoperative inspection, palpation and IOUS remains the golden standard in the diagnosis and staging of liver tumors.