Doppler perfusion index fails to predict the presence of occult hepatic colorectal metastases

Aims To assess the predictive value of the Doppler perfusion index (DPI) in a cohort of patients with colorectal cancer with and without initial metastatic disease and present the data of at least 4 years follow-up. Methods We studied 133 patients admitted with stage I–IV colorectal cancer. In all patients hepatic flow measurements were performed in the week before surgery. All patients who underwent curative surgery on intention were followed up for at least 4 years. Results Reliable DPI measurements were not possible in 29 patients. Three groups were defined for comparison: (A) 57 patients who remained disease free, (B) 11 patients who presented with metachronous liver metastases during follow-up and (C) 19 patients with liver metastases at initial presentation. No significant difference was found for DPI data between the three groups. There was a trend for a higher hepatic artery flow in patients with initial liver metastases compared to those who remained disease free (p=0.07). The previously reported cut-off point for maximal normal DPI (0.3) did not have any predictive value in this patient cohort. Conclusion The present data do not confirm the usefulness of DPI measurements in daily clinical practice for the early identification of patients with colorectal cancer at high risk for recurrent disease.