ABSTRACT
Assessments of the sensitivity of imaging techniques for detecting metastases are heavily dependent on the method used to establish the absence of disease-how “true” are the “true negative” cases. Direct examination of the liver by an experienced surgeon assisted by intraoperative ultrasound will reveal additional metastases in a small proportion of patients (about 6% in our experience) compared with optimum pre-operative imaging. Pathological examination of the excised liver specimen, particularly if sliced at 3-4 mm intervals, occasionally detects further very small lesions.
