In addition to a halo, metastases may take on a "target" or "bull's-eye" appearance due to alternating layers of hyper- and hypoechoic tissue. Like a halo, such patterns are also highly suggestive of malignancy. A uniformly hyperechoic solid mass is usually a benign hemangioma.
Ultrasonography (US) is widely used in the investigation of suspected liver metastases. Intraoperative US (IOUS) of the liver has the highest sensitivity for the detection of focal liver abnormalities, with 96% accuracy; by contrast, the accuracy of transabdominal US is 84%.
The appearance of metastases on ultrasound is diverse, but most appear rounded with sharp or smooth margins. They show variable echogenicity (hypo-, iso, or hyperechoic relative to the surrounding parenchyma), with the hypoechoic pattern being the most common (65%)[7].
Metastasis is the spread of cancer cells to distant areas of the body, often by way of the lymph system or bloodstream. Metastasis is sometimes mistakenly referred to by the generic misnomer metastatic carcinoma.
Ultrasound can usually help differentiate between benign and malignant tumours based on shape, location, and a number of other sonographic characteristics. If the ultrasound is inconclusive, your doctor may request follow-up ultrasound to monitor the tumor or a radiologist may recommend a biopsy.
Because sound waves echo differently from fluid-filled cysts and solid masses, an ultrasound can reveal tumors that may be cancerous. However, further testing will be necessary before a cancer diagnosis can be confirmed.
Metastatic cancer is diagnosed with imaging (CT scans, MRIs, and/or PET scans) to determine the extent of disease and with a biopsy of a tumor so that a pathologist can identify the specific type of cancer. There are many treatments for metastatic cancer.
CT scanning and MRI are useful in evaluating suspicious bone scintiscan findings that appear equivocal on radiographs. MRI can also help detect metastatic lesions before changes in bone metabolism make the lesions detectable on bone scintiscans.
Alpha-fetoprotein (AFP) is the most widely used tumor marker for detecting liver cancer. However, other cancers and certain conditions, including pregnancy, hepatitis, and other types of cancer, may also increase AFP levels.
In addition to liver function tests, doctors use imaging tests to diagnose liver metastases. These may include MRI, CT scan, ultrasound, or PET scan. Sometimes, doctors use a combined PET scan and CT scan. Doctors also may order a biopsy to confirm liver metastasis.
Cancerous tissue also shows up as white on a mammogram. Therefore it is sometimes hard to distinguish dense tissue from cancerous tissue. On an ultrasound cancerous tissue shows up black and dense tissue is still white, therefore cancers are easier to distinguish.
Magnetic resonance imaging (MRI) with contrast enhancement is the procedure of choice because MRI is more sensitive and specific than other imaging modalities in determining the presence, location, and numbers of metastases.
Ultrasound, CT, and MRI are helpful in detecting hepatic metastases and evaluation across multiple post-contrast CT series, or MRI pulse sequences are necessary.
The main tests for metastases are: Blood tests to check for spread to the liver or bones. Bone scans to check for spread to the bones. X-rays and/or CT scans to check for spread to the chest, abdomen or liver.
A University of Oxford study published in Clinical Cancer Research, a journal of the American Association for Cancer Research, outlines a new type of blood test that can be used to detect a range of cancers and whether these cancers have spread (metastasised) in the body.
Most metastases, however, occur within 10 years after removal of the primary tumor.
The liver is the most common site of distant metastasis in solid tumors.
Cancer metastasizes due to several factors, namely attack by the immune system, lack of oxygen and necessary nutrients, large amounts of lactic acid produced by glycolysis and increased cell death. Therefore, the majority of the presently available treatments for cancer also bear the potential to induce metastasis.
Metastatic brain tumors can grow rapidly, crowding or destroying nearby brain tissue. Sometimes a patient may have multiple metastatic tumors in different areas of the brain.
Based on the heterogeneity of stiffness between different tumor tissues, ultrasound elastography can distinguish between benign and malignant tumors by detecting the modulus of elasticity (10).
An example of early signs that may not show up on ultrasound are tiny calcium deposits called microcalcifications. Ultrasound may be used if you: Have particularly dense breast tissue. A mammogram may not be able to see through the tissue.
What does red or blue mean on an ultrasound? Red and blue colors represent the movement of the blood. Blue represents blood flow away from the probe, while red represents the blood flowing towards the probe.