 Studies suggest that EUS may be an attractive alternative to CT scan for detection of the liver metastases, since it can detect lesions that are missed on the CT scan 9. EUS detected metastatic lesions overlooked by conventional, cross-sectional imaging studies in 5 of 222 cases 2.3 9. Another study found occult liver metastases in 2.4 of 574 patients with suspected GI or pulmonary malignancies 4. Each patient found to have occult metastases at EUS had staging CT, which raises an issue as to the quality andor interpretation of those studies. 