A Prospective Analysis of Laboratory Tests and Imaging Studies To Detect Hepatic Lesions

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Abstract
A prospective study of the ability of laboratory tests and liver imaging tests to detect hepatic metastases was performed. Eighty patients at risk for hepatic metastases but without clinical evidence of disease were tested with 13 laboratory tests and 3 liver imaging tests. No single laboratory test had > 65% accuracy in the detection of hepatic lesions. No combination of the laboratory tests increased this accuracy. If the laboratory tests were used with 1 of the liver imaging tests, the accuracy was improved in some combinations to 76%. The CEA [carcinoembryonic antigen] assay when analyzed in patients with colorectal primaries had an accuracy of 79%. Laboratory tests alone apparently are not sufficiently accurate to detect liver metastases. Additional accuracy can be obtained by the combined use of a single liver imaging test and selected laboratory tests. Use of all the liver imaging tests and laboratory tests lowers the accuracy and increases the expense and thus is unnecessary.