Patients with stage IV A colorectal cancer still have possibilities of treatment and disease control. This is particularly true in those subjects with resectable liver metastases or with liver metastases becoming resectable after neoadjuvant chemotherapy (ChT). In patients with resectable liver lesions, it has been shown that ChT improves the overall treatment results. ChT can be carried out as a neoadjuvant or as an adjuvant treatment, with the choice between the two is still debated.

Antiangiogenetic drugs offer new possibilities for the neoadjuvant therapy. However, their effects cannot be adequately assessed on the sole basis of dimensional data (WHO criteria and RECIST). A variety of “new” imaging modalities have been employed to obtain morpho-functional information on the effectiveness of ChT with antiangiogenetic drugs. These include perfusion CT, perfusion MRI, diffusion-weighted MRI, and qualitative-quantitative contrast-enhanced sonography (CEUS). As a matter of facts, it is important to early discriminated responders from not-responders, avoiding both hypotreatment and hypertreatment.

The purpose of our prospective study was to compare the effectiveness of qualitative CEUS and multidetector CT in the assessment of response to neoadjuvant therapy in patients with liver metastasis from colorectal cancer.