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[Ultrasound, computed tomography and laparoscopy. Efficacy in the detection of primary and metastatic hepatic tumors.
C Gumina1, R Monserat, M Bronstein
1Hospital Oncológico Padre Machado, Caracas, Venezuela.
Object:
To compare ultrasound, computed tomography and peritoneoscopy in the diagnosis of primary and metastatic hepatic tumors.
Design:
Prospective trial of a cohort patients during a year.
Place:
Digestive Disease Department in a National referral Cancer Center.
Patients:
Forty five patients with intraabdominal tumors for pretreatment evaluation. Intervention; Ultrasonography, computed tomography and peritoneoscopy performed in a period of ten days.
Measurements:
sensibility, specificity and efficiency comparison of results by Chi square test, with Yates correction (X2 Yates), measure of pre test and post test probabilities using Bayes theorem.
Results:
In hepatic humors, peritoneoscopy was the most sensitive, specificity was similar for the three procedures (p greater than 0.1), in the detection of hepatic metastases peritoneoscopy was the most sensitive 91.6% vs 50% (p less than 0.05) similar specificity and high positive predictive value for the three procedures, comparable with the post test probabilities.
Conclusions:
In the detection of focal hepatic lesions, peritoneoscopy was the best method; in case of doubt, failure of non invasive procedures or the need of biopsy samples must be considered the procedure of choice.