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Background <p>Liver metastases, particularly small-sized ones, may not be detected by conventional imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). However, endoscopic ultrasound (EUS) has been shown to be more effective in identifying these occult lesions. Moreover, EUS-guided fine needle aspiration/biopsy (EUS-FNA/B) has been recognized for significantly improving diagnostic accuracy. This study aimed to assess the feasibility of EUS for the detection of hepatic focal lesions (HFLs) that are not visible on CT or MRI during the staging of primary tumors.</p> Methods <p>This prospective study involved 300 patients who underwent EUS for staging or biopsy of gastrointestinal or pancreatic cancers. Liver examination was conducted to identify occult lesions, with CT or MRI performed within one week of EUS examination.</p> Results <p>EUS identified HFLs in 67 patients (22.3%), with metastases detected in 56 patients (16.3%). In comparison, CT and MRI detected HFLs in 49 patients (16.3%) and metastases in 39 patients (13%). EUS missed HFLs in 6 patients, 3 of them having liver metastases, whereas CT and MRI missed HFLs in 24 patients, 20 of them having liver metastases, which were subsequently detected by EUS and confirmed by EUS-guided tissue acquisition (EUS-TA).</p> Conclusion <p>A comprehensive EUS examination of the liver is a feasible and effective method in detecting HFLs that may be overlooked by CT and MRI. Furthermore, EUS-TA offers an additional diagnostic advantage.</p>

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EUS versus contrast radiographic imaging in the diagnosis of liver metastases

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月30日

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  • Ahmed Mohamed Mady,
  • Ahmed Mohamed Sadek,
  • Hussein Hassan Okasha,
  • Rasha Omar Refaie,
  • Ibrahim Abd El-Ghani Motawea

摘要

Background

Liver metastases, particularly small-sized ones, may not be detected by conventional imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). However, endoscopic ultrasound (EUS) has been shown to be more effective in identifying these occult lesions. Moreover, EUS-guided fine needle aspiration/biopsy (EUS-FNA/B) has been recognized for significantly improving diagnostic accuracy. This study aimed to assess the feasibility of EUS for the detection of hepatic focal lesions (HFLs) that are not visible on CT or MRI during the staging of primary tumors.

Methods

This prospective study involved 300 patients who underwent EUS for staging or biopsy of gastrointestinal or pancreatic cancers. Liver examination was conducted to identify occult lesions, with CT or MRI performed within one week of EUS examination.

Results

EUS identified HFLs in 67 patients (22.3%), with metastases detected in 56 patients (16.3%). In comparison, CT and MRI detected HFLs in 49 patients (16.3%) and metastases in 39 patients (13%). EUS missed HFLs in 6 patients, 3 of them having liver metastases, whereas CT and MRI missed HFLs in 24 patients, 20 of them having liver metastases, which were subsequently detected by EUS and confirmed by EUS-guided tissue acquisition (EUS-TA).

Conclusion

A comprehensive EUS examination of the liver is a feasible and effective method in detecting HFLs that may be overlooked by CT and MRI. Furthermore, EUS-TA offers an additional diagnostic advantage.