Computed tomography and peritoneoscopy for detection of liver metastases: review of Mayo Clinic experience

The effectiveness of computed tomography (CT) and peritoneoscopy in detecting liver metastasis was studied by review of 97 cases in which both of these procedures and also biopsy or autopsy were performed. Tissue examinations disclosed hepatic lesions in 45 cases. The sensitivity of CT and peritoneoscopy was 89 and 62%, respectively; and their specificity 94 and 96%. In 35% of biopsy-proven cases, CT detected lesions not visible at peritoneoscopy; and in 7% peritoneoscopy revealed lesions not shown by CT. The difference resulted from the more frequent occurrence of liver metastases in locations more suitable for CT detection. The results suggest that CT should be tried before peritoneoscopy (other considerations being equal), and that CT guidance for biopsy deserves more frequent use. The reliability of negative CT or peritoneoscopy findings remains uncertain, since autopsy has been obtained in only 3 of the 52 negative cases.