Liver ultrasound screening: A good recommendation for patients with uveal melanoma

This study evaluated the effectiveness of ultrasound exams for the early detection of melanoma spread to the liver. The authors found that regular scans could be used to effectively detect cancer spread to the liver among uveal melanoma patients. 

Uveal melanoma is a rare cancer of the eye. Uveal melanoma is associated with a high risk of metastasis (cancer spread to other organs). Almost 90% of eye melanoma patients eventually develop liver metastasis. Early detection of cancer spread is important for any possible treatment. This study assessed the use of routine liver ultrasound exams (a non-harmful and non-invasive imaging test) to detect early liver metastasis.

263 patients with uveal melanoma were included in this study. All patients received liver ultrasound screening every 6 months for the first 5 years following initial treatment, and yearly thereafter. A total of 1390 liver ultrasounds were carried out. Overall, 86 ultrasound results (among 71 patients) were reported as abnormal.

Of the 71 patients with abnormal findings, 13 patients had findings classified as having a low probability of being cancer according to ultrasound. Confirmatory tests showed that 1 of these was in fact a case of liver metastasis (8%). 17 patients had findings classified as having an indeterminate probability of being cancer. Confirmatory tests showed that 1 of these was in fact a case of liver metastasis (6%).

36 patients had findings suspicious for cancer spread according to ultrasound. Confirmatory tests showed that 23 of these were indeed cases of liver metastasis (64%). 5 patients had findings classified as having a high probability of being cancer according to ultrasound. Confirmatory tests showed that indeed all 5 were cases of liver metastasis (100%).

By comparison, blood tests checking for liver function abnormalities were suspicious in only 4 of the 30 patients with liver metastasis (13%).

The authors concluded that regular liver ultrasounds is an effective screening strategy for the early detection of liver metastasis in uveal melanoma patients.