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Computed tomography or contrast‐enhanced ultrasonography for follow‐up of liver metastases after Cyberknife therapy?: A prospective pilot study
Author(s) -
Marsico Maria,
Gabbani Tommaso,
Lunardi Sarah,
Lei Barbara,
Lucarini Matteo,
Cuffari Biagio,
Curatolo Angela,
Biagini Maria Rosa,
Annese Vito
Publication year - 2019
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.14734
Subject(s) - medicine , cyberknife , concordance , radiology , prospective cohort study , ultrasonography , nuclear medicine , radiation therapy , radiosurgery
Objectives Contrast‐enhanced ultrasonography (CEUS) allows the study of vascularization of secondary liver lesions. The Cyberknife (Accuray, Inc, Sunnyvale, CA) is a therapeutic method that allows a tumor target to be subjected to a high radiant dose gradient. This prospective pilot study aimed to demonstrate the concordance of CEUS versus contrast‐enhanced computed tomography (CECT) in determining the stability or disease progression of secondary liver lesions after treatment with the Cyberknife. Methods Twenty‐four patients were consecutively enrolled, and 3 different operators evaluated the CEUS images and the intermodality concordance with CECT. All patients received CEUS at 1 and 2 months after the Cyberknife therapy. The intermodality agreement was evaluated by the Cohen κ coefficient and a multivariate analysis according to the method of Janson and Olsson ( Educ Psychol Meas 2001; 61:277–289). Results Forty secondary liver lesions were detected and treated. Forty‐one CECT and 51 CEUS examinations were performed without any adverse events in the 24 patients. The intermodality agreement rates, calculated for the operators as Cohen κ values, were κ = 1.00, 0.881, and 0.767, respectively. The multivariate analysis of intermodality agreement showed an almost perfect value (ι = 0.841). Conclusions This pilot study found excellent diagnostic correspondence between CEUS and CECT in the evaluation of local disease stability or progression after Cyberknife therapy in liver metastases. These findings suggest that CEUS could play an important role in the surveillance of these patients because of its high accuracy and reproducibility, thus reducing the need for CECT.