{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T12:41:07Z","timestamp":1769172067192,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,3]],"date-time":"2021-01-03T00:00:00Z","timestamp":1609632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,1,3]],"date-time":"2021-01-03T00:00:00Z","timestamp":1609632000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,1,3]],"date-time":"2021-01-03T00:00:00Z","timestamp":1609632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Glisson invasion by CLM is associated with a risk of margin\u2010positive resection, leading to poor long\u2010term outcomes after hepatectomy. This study was performed to evaluate the efficacy of intraoperative ultrasonography (IOUS) for the diagnosis of Glisson's capsule invasion by colorectal liver metastasis (CLM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective study involved 50 consecutive patients undergoing hepatectomy for CLM. Preoperatively, all patients had undergone gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid\u2010enhanced magnetic resonance imaging (EOB\u2010MRI). During hepatectomy, a contrast agent (perflubutane) was intravenously injected and Glisson invasion was estimated based on three characteristic findings: a tumor thrombus, peripheral dilatation, and border irregularity\/caliber change. The diagnostic abilities of the preoperative and intraoperative imaging studies were evaluated based on pathological examinations of resected specimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 187 CLMs resected, pathological examinations proved Glisson invasion in 24 tumors (13%). IOUS revealed a tumor thrombus in 3 tumors (1.6%), peripheral dilatation in 4 (2.1%), and border irregularity and\/or caliber change in 24 (12.8%). The sensitivity and specificity of IOUS with any of the above three findings for diagnosis of Glisson invasion was 79% and 96%, respectively, while preoperative EOB\u2010MRI detected Glisson invasion in only four tumors (sensitivity\/specificity, 17%\/100%). The cutoff value of caliber change for diagnosis of Glisson invasion was set at 140% by receiver operating characteristic analysis. The R0 resection rates were not significantly different between patients with (82%) and without (85%) Glisson invasion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Identification of characteristic findings (tumor thrombus, peripheral dilatation, and border irregularity\/caliber change) by contrast\u2010enhanced IOUS is useful for the prediction of Glisson invasion by CLM.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05883-7","type":"journal-article","created":{"date-parts":[[2021,1,3]],"date-time":"2021-01-03T18:03:05Z","timestamp":1609696985000},"page":"1168-1177","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Identification of Glisson's Capsule Invasion During Hepatectomy for Colorectal Liver Metastasis by Contrast\u2010Enhanced Ultrasonography Using Perflubutane"],"prefix":"10.1002","volume":"45","author":[{"given":"Junko","family":"Hiroyoshi","sequence":"first","affiliation":[{"name":"Department of Surgery, Graduate School of Medicine Hepato\u2010Biliary\u2010Pancreatic Surgery Division, The University of Tokyo 7\u20103\u20101 Hongo, Bunkyo\u2010ku 113\u20108655 Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeaki","family":"Ishizawa","sequence":"additional","affiliation":[{"name":"Department of Surgery, Graduate School of Medicine Hepato\u2010Biliary\u2010Pancreatic Surgery Division, The University of Tokyo 7\u20103\u20101 Hongo, Bunkyo\u2010ku 113\u20108655 Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Pathology, Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junichi","family":"Arita","sequence":"additional","affiliation":[{"name":"Department of Surgery, Graduate School of Medicine Hepato\u2010Biliary\u2010Pancreatic Surgery Division, The University of Tokyo 7\u20103\u20101 Hongo, Bunkyo\u2010ku 113\u20108655 Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhisa","family":"Akamatsu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Graduate School of Medicine Hepato\u2010Biliary\u2010Pancreatic Surgery Division, The University of Tokyo 7\u20103\u20101 Hongo, Bunkyo\u2010ku 113\u20108655 Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junichi","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Surgery, Graduate School of Medicine Hepato\u2010Biliary\u2010Pancreatic Surgery Division, The University of Tokyo 7\u20103\u20101 Hongo, Bunkyo\u2010ku 113\u20108655 Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuo","family":"Ushiku","sequence":"additional","affiliation":[{"name":"Department of Pathology, Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8734-740X","authenticated-orcid":false,"given":"Kiyoshi","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Surgery, Graduate School of Medicine Hepato\u2010Biliary\u2010Pancreatic Surgery Division, The University of Tokyo 7\u20103\u20101 Hongo, Bunkyo\u2010ku 113\u20108655 Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,3]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Surgical anatomy of the liver revisited:Self\u2010printed","author":"Couinaud C","year":"1989"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199501000\u201000009"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039\u20106060(99)70022\u2010X"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1155\/2000\/17619"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440\u20101827.2002.01382.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010006\u20100205\u20103"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318293ddf1"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2019.01.023"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b4539b"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010015\u20105009\u2010y"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2019.12.004"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001085"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.8844"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12328\u2010018\u20100858\u20100"},{"key":"e_1_2_9_16_1","doi-asserted-by":"crossref","unstructured":"HuangM LiaoB Xu p et al. 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