Characterization of focal liver lesions: comparative study of contrast-enhanced ultrasound versus spiral computed tomography

Abstract

The purpose of this study was to compare the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) with spiral computed tomography (SCT) for the characterization of focal liver lesions (FLL) and to determine the degree of correlation between the two techniques. Seventy-seven FLL (45 hepatocellular carcinomas; 12 metastases; ten hemangiomas; two regenerating/dysplastic nodules; eight focal nodular hyperplasias) detected with ultrasound (US) were prospectively evaluated by CEUS using a second-generation contrast agent and SCT (with an interval of no more than one month between the two techniques). Independent observers made the most probable diagnosis and the results were compared with the final diagnoses (histology n = 59; MRI n = 18). Statistical analysis was performed by the Chi-square and Kappa tests. CEUS provided a correct, specific diagnosis in 69/77 (90%) of the FLL, while SCT did so in 67/77 (87%). The sensitivity, specificity, and diagnostic accuracy for malignancy were 91%, 90%, and 91%, respectively, for CEUS and 88%, 89%, and 88%, respectively, for SCT. No statistically significant difference was found between CEUS and SCT in the characterization of FLL (p > 0.05). In addition, agreement between the two imaging techniques was good (k = 0.75). We conclude that CEUS and SCT provide a similar diagnostic accuracy in the characterization of FLL, with a good degree of correlation between the two techniques.

Quantitative analysis of contrast-enhanced ultrasonography: differentiating focal nodular hyperplasia from hepatocellular carcinoma

“…The enhancement patterns of the lesion are evaluated in three vascular phases (the hepatic arterial, portal venous and late phases), where the hepatic arterial phase provides information on the degree and pattern of vascularity and the portal venous and late phases provide important information on the differention between benign and malignant liver lesions [1]. A previous study has shown that CEUS using SonoVue® (Bracco, Milan, Italy) and spiral-CT provides similar diagnostic accuracy in the characterisation of focal liver lesions [2].…”

“…Most malignant tumours show predominantly microbubble washout, while benign tumours show persistent microbubble uptake on CEUS with a low-mechanical-index mode and a sulphur hexafluoride-filled microbubble contrast agent [1,2,5]. Despite this, enhancement in the late phase provides important information about the nature of the lesion.…”

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

“…CEUS significantly improved the diagnostic performance in small FLLs compared to BUS [8] . Several other studies also provided evidence that CEUS has sensitivity and specificity similar to computed tomography (CT) and magnetic resonance imaging (MRI) in terms of detection and characterization of FLLs [9][10][11][12] . In this article, the application of CEUS for the detection of different benign and malignant FLLs in liver cirrhosis will be described and discussed on the basis of our experience and latest literature data.…”

The Role of Multimodality Imaging Techniques on Differential Diagnosis of Precancerous Nodules and Hepatocellular Carcinoma

“…Previous studies have shown that contrast-enhanced ultrasound, computer tomography (CT), and magnetic resonance imaging (MRI) have the same sensitivity and specificity for screening and identifying small liver nodules [7][8][9]. It is generally believed that most of DNs are enhanced synchronically with the surrounding liver parenchyma [10].…”