Evaluation of intrahepatic tumour extent and prediction of resection size in liver tumours by computed tomography, ultrasonography and angiography.

Preoperative radiologic examinations were reviewed in 110 patients planned for liver resection. Forty-five patients had a CT examination within a month before the operation; 22 of these also had ultrasonography (US) and 38 had angiography. In a numeric analysis of lesions, true positive findings were observed at CT and US in 69 per cent and 61 per cent, respectively. Angiography, mainly performed to show the vascular anatomy and patency of the portal vein and not to optimize tumour detection, showed 55 per cent of the lesions. Attempts were made to predict resection size with CT by estimating intrahepatic tumour extent. CT showed correct tumour extent in 73 per cent but was inaccurate in 12 of 45 examinations. In 5 of these, tumour growth across the main and sagittal fissures was misinterpreted, with both under- and overestimations. Improvements of current imaging methods are needed to make the radiologic assessment prior to liver surgery more reliable.