Comparison of contrast-enhanced ultrasonography with grey-scale ultrasonography and contrast-enhanced computed tomography in diagnosing focal fatty liver infiltrations and focal fatty sparing

Janica, Jerzy; Ustymowicz, Andrzej; Łukasiewicz, Adam; Panasiuk, Anatol; Niemcunowicz‐Janica, Anna; Turecka-Kulesza, E; Łebkowska, Urszula

doi:10.2478/ams-2013-0027

Cited by 13 publications

(15 citation statements)

References 55 publications

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“…Although uncommon patterns of contrast-enhancement of either fatty change or focal sparing in the liver have already been reported, to our knowledge this is the first report of an area of fatty change of the liver showing a hypoechoic pattern in the portal-venous phase [8,11,27]. This finding is partly related to the strict criteria adopted for malignancy in this study, where any hypoenhancing area in the portal-venous phase was considered malignant.…”

Section: Discussionsupporting

confidence: 49%

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Detection of liver metastases in cancer patients with geographic fatty infiltration of the liver: the added value of contrast-enhanced sonography

et al. 2017

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PurposeThe aim of this study is to assess the role of contrast-enhanced ultrasonography (CEUS) in the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale ultrasonography (US).MethodsThirty-seven consecutive cancer patients (24 women and 13 men; age, 33 to 80 years; mean, 58.1 years) with geographic liver fatty deposition, but without any detectable focal liver lesion on greyscale US, underwent sulphur hexafluoride-enhanced US. Two readers reported by consensus the presence, size, and location of any detected lesion. All patients underwent magnetic resonance imaging (MRI) as a confirmatory study. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy were calculated.ResultsSeven focal liver lesions (size, 4 to 10 mm; mean, 6.1 mm) were detected in 4/37 patients (10.8%): four metastases (size, 5 to 10 mm; mean, 6.7 mm) were detected both by CEUS and MRI, with one hemangioma and two cysts (size range, 4 to 6 mm; mean, 5.3 mm) detected by MRI only. In 1/37 patients (2.7%), CEUS misdiagnosed geographic fatty change as three metastases. In 32/37 patients (86.5%), no lesions were detected. Sensitivity, specificity, PPV, NPV, and accuracy of CEUS were 100% (95% confidence Interval [CI], 1.000 to 1.000), 97.1% (95% CI, 0.914 to 1.027), 75%, 100%, and 97.3%, respectively. No statistically significant differences were found between CEUS and MRI in the detection of focal liver lesions (P=0.480), whereas both of them performed better than baseline US (P<0.001).ConclusionCEUS improves the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale US.

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Section: Discussionsupporting

confidence: 49%

“…Diagnostic criteria for liver metastases and fatty change of the liver at CEUS and MRI with hepatocellular specific contrast agent are reported in Tables 1 and 2, respectively [8,12-14]. …”

Section: Methodsmentioning

confidence: 99%

Detection of liver metastases in cancer patients with geographic fatty infiltration of the liver: the added value of contrast-enhanced sonography

et al. 2017

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“…On visualization of possible focal fat infil-tration, atypical location or history of malignancy should prompt further characterization to exclude malignant lesions. Focal fatty change shows the same degree of enhancement (isoenhancing) as the surrounding liver parenchyma during all phases [92,103]. Typically, a centrally located artery can be identified [82,92,104].…”

Section: Focal Fatty Changementioning

confidence: 99%

Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2020 – WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS

et al. 2020

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The present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS), first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications.The 2012 guideline requires updating as previously the differences of the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including the United States Food and Drug Administration (FDA) approval as well as the extensive Asian experience, to produce a truly international perspective.These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCA) and are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis to improve the management of patients.

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“…In a Chinese study the reported sensitivity of CEUS in the diagnosis of focal fatty alterations was 88% and its overall accuracy was 96% [27]. In a Polish study, CEUS had 95.8% sensitivity, 100% specificity and 99.6% accuracy to diagnose focal fatty liver infiltrations, while for focal fatty sparing the sensitivity was 91.2%, the specificity 100%, with 99.4% accuracy [28]. In the Romanian multicentre study, CEUS had 96.6% sensitivity, 86.7% specificity and 87.3% accuracy to diagnose focal fatty alterations [13].…”

Section: Livermentioning

confidence: 96%

Romanian National Guidelines on Contrast Enhanced Ultrasound in clinical practice

et al. 2017

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Contrast-enhanced ultrasound (CEUS) allows a real-time assessment of the vascular pattern of different types of lesions, as it has no renal or liver toxicity, it lacks radiation exposure and it is also cheaper than other imaging methods, having a diagnostic capability that matches contrast-enhanced CT or MRI. In Romania CEUS is used more and more, especially by clinicians, and since some centres have extensive experience in this domain, we felt the need to disseminate our expertise in order to implement this method in as many centres as possible. These Guidelines present the clinical applications of CEUS in the liver, spleen, pancreas, kidney, testis, bowel, intra-cavitary and endoscopic ultrasound, as well as other applications.

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Comparison of contrast-enhanced ultrasonography with grey-scale ultrasonography and contrast-enhanced computed tomography in diagnosing focal fatty liver infiltrations and focal fatty sparing

Cited by 13 publications

References 55 publications

Detection of liver metastases in cancer patients with geographic fatty infiltration of the liver: the added value of contrast-enhanced sonography

Detection of liver metastases in cancer patients with geographic fatty infiltration of the liver: the added value of contrast-enhanced sonography

Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2020 – WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS

Romanian National Guidelines on Contrast Enhanced Ultrasound in clinical practice

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