Computed tomography, ultrasound, and scintigraphy of the liver in patients with colon or breast carcinoma: a prospective comparison.

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Abstract
A prospective evaluation of computed tomography (CT), ultrasonography (US), and 99mTc sulfur colloid scintigraphy of the liver was performed in 189 patients who had either colon (n = 129) or breast (n = 60) carcinoma. Imaging was performed with 4th-generation CT scanners, gray-scale or phased array ultrasound scanners, and 37 tube gamma cameras. Studies were evaluated independently and receiver operating characteristic (ROC) curves were constructed. In addition, a standard 2 .times. 2 matrix analysis was performed. In patients who had all 3 examinations (n = 122), the matrix analysis showed that CT had a slightly higher sensitivity (0.93) than scintigraphy (0.86) or US (0.82); specificities were 0.88, 0.83, and 0.85, respectively. These differences were not statistically significant. However, ROC showed that CT had the highest true-positive ratio at every false-positive ratio, and that US had the lowest. The performance of CT did not differ significantly from that of scintigraphy, but was better than that of US (P < 0.05), especially in patients with breast carcinoma. Overall, CT provided the most accurate means for detecting liver metastases from both primary lesions.

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