The present brief clinical report showed that Contrast-enhanced intraoperative ultrasonography (CE-IOUS) using a new microbubble agent, Sonazoid, can allow surgeons to investigate the whole liver with enough time and to find new metastases intraoperatively.
Contrast-enhanced intraoperative ultrasonography (CE-IOUS) seems more sensitive than conventional IOUS to identify new occult lesions during hepatectomy in patients with colorectal cancer liver metastases (CRCLM). However, conventional contrast mediums cannot provide enough time for repeat whole liver intraoperative scan, and further improvement of microbubble agent for CE-IOUS had been sought.
A brief clinical article to be published on January 28, 2008 in the World Journal of Gastroenterology addresses this question. A clinical team led by Dr. Nakano from Asahi-Chuo General Hospital used Sonazoid (perfluorobutane, GE Helthcare, Oslo, Norway), which is a new microbubble agent that provides late Kupffer-phase image.
They showed that CE-IOUS using Sonazoid provided the late Kupffer-phase image for at least 30 min following hepatic vascular-phase image for the first 10 min after the injection. They also showed that occult metastases, which had not been detected preoperatively by CT, MRI or CE-US, were newly found in two of the eight patients with CRCLM.
Sonazoid seems the most suitable microbubble agent for CE-IOUS, and may reduce intrahepatic recurrence and improve survival after hepatectomy in patients with CRCLM.