Arrival time parametric imaging using Sonazoid-enhanced ultrasonography is useful for the detection of spoke-wheel patterns of focal nodular hyperplasia smaller than 3 cm

Abstract

It is considered difficult to make a definitive diagnosis of focal nodular hyperplasia (FNH) of <3 cm when using conventional diagnostic imaging modalities. Typical FNH imaging findings are: i) central scar formation, ii) nutrient vessels extending radially from the center and iii) the presence of Kupffer cells. In a clinical setting, identification of a spoke-wheel pattern formed by nutrient vessels extending radially is a key feature in the diagnosis of FNH. In this study, we investigated the detection rate of spoke-wheel patterns of FNH <3 cm using arrival time parametric imaging (At-PI) technology with Sonazoid-enhanced ultrasonography (US). Five patients with FNH <3 cm who had undergone Sonazoid-enhanced US at the Toho University Omori Medical Center between February 2008 and March 2009 were included in the study. The mean tumor diameter was 20.2±7.2 mm. Lesions were enhanced with 0.5 ml Sonazoid US contrast agent and a video of the procedure was saved and used for At-PI analysis of contrast agent dynamics in FNH. Three ultrasonographic specialists examined the images and made a diagnosis of FNH based on the findings of spoke-wheel patterns. Similarly, micro-flow imaging (MFI) was performed to evaluate the contrast agent dynamics in FNH. Using MFI, FNH was diagnosed in 3 of the 5 cases by the three specialists, whereas At-PI enabled the identification of spoke-wheel patterns in all 5 cases. At-PI using Sonazoid-enhanced US is superior for detecting spoke-wheel patterns of FNH <3 cm.

Differentiation of atypical hepatic hemangioma from liver metastases: Diagnostic performance of a novel type of color contrast enhanced ultrasound

“…The arrival time was defined as zero and represented the time differences in different colors. A few studies demonstrated that CPI was useful in the diagnosis of hepatic parenchymal diseases [11,12] and in identifying spoke-wheel patterns of FNH [13] . To our knowledge, this is the first study to analyze whether CPI could provide useful information to differentially diagnose atypical hemangioma and liver metastases.…”

Enhanced Ultrasonography Using a Nano/Microbubble Contrast Agent for Islet Transplantation

“…(E) The increase in the echogenicity in the Tx group was more prominent at POD 56 than at POD 14. was used to detect liver tumors in animal models (24,25) and in the clinic (26). Currently, the second-generation contrast agent, Sonazoid 1 (NC100100), is widely used to detect many types of gastroenterological tumor (27)(28)(29)(30).…”

Impact of parametric imaging on contrast-enhanced ultrasound of breast cancer

“…It enables color display reflecting real-time changes in hemodynamics. In hepatic lesions, it has been reported that parametric images may be used to obtain detailed hemodynamic information of the hepatic parenchyma and make a diagnosis of hepatic disease [8][9][10][11]. In breast lesions, previous studies suggest that parametric imaging is useful for differentiating between malignant and benign breast tumors [12,13].…”