How Reliable Is Ultrasound for Detection and Follow Up on Breast Cancer Liver Metastases?

BACKGROUND: To find out whether and to what extent the two diagnostic methods are necessary – both the computed tomography and the ultrasound for diagnosis and staging at the same time on breast cancer liver metastases. AIM: In order to protect patients from unnecessary CT ionizing radiation, we compared the level of agreement of two methods: ultrasound and computed tomography. METHODS: We analyzed 41 patients with diagnosed breast cancer and synchronous liver metastases. RESULTS: There is a poor level of agreement between the ultrasound and computed tomography in the arterial and portal phase in terms of showing hepatic metastases in primary breast cancers. The individual kappa values calculated for each category individually, show that the two methods agree best in detecting ring changes (0.573) and do not agree at all in detecting hyper lesions. CONCLUSION: Only ultrasound is sufficient in the diagnosis and monitoring of annular hepatic metastases, because it best agrees with computed tomography in the arterial and venous phase, while computed tomography is the only method of choice for hyperechoic metastases. When it comes to hypoechoic metastases the computed tomography remains the gold standard for diagnosis in our institution.