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Liver function tests in patients with computed tomography demonstrated hepatic metastases
M D Ottmar1, R L Gonda, K J Leithauser
1Department of Diagnostic Imaging and Interventional Radiology, Providence Hospital, Southfield, Michigan 48037.
Gastrointestinal Radiology
|January 1, 1989
Summary
Liver function tests (LFTs) often fail to detect liver metastases, even in advanced cases. Many patients with confirmed liver metastases showed normal enzyme levels, questioning the reliability of LFTs for screening.
Area of Science:
- Hepatology
- Medical Diagnostics
- Oncology
Background:
- Liver metastases are a common complication of various cancers.
- Liver function tests (LFTs) are routinely used to assess liver health.
- The sensitivity of LFTs in detecting liver metastases is not well-established.
Purpose of the Study:
- To evaluate the efficacy of standard liver function tests (LFTs) in detecting liver metastases.
- To determine the proportion of patients with liver metastases who exhibit normal LFTs.
Main Methods:
- One hundred patients with confirmed liver metastases (via CT scan and biopsy/progression) were studied.
- Serum levels of alkaline phosphatase, AST, and ALT were measured within two weeks of CT.
- Patients were categorized based on the extent of liver involvement.
Main Results:
- 33% of patients with liver metastases had normal levels for all three tested liver enzymes.
- Even in cases with advanced disease (≥3 lesions >3 cm), 20% had normal LFTs.
- Standard LFTs failed to detect a significant proportion of liver metastases.
Conclusions:
- Standard liver function tests (LFTs) have limited sensitivity for detecting liver metastases.
- A substantial number of patients with liver metastases may present with normal enzyme levels.
- Relying solely on LFTs may lead to missed diagnoses of liver metastases.