Comparison of the Feasibility and Diagnostic Performance of <scp>ACR CEUS LI‐RADS</scp> and a Modified <scp>CEUS LI‐RADS</scp> for <scp>HCC</scp> in Examinations Using Sonazoid

Liao, Wei; Que, Qiao; Wen, Rong; Lin, Peng; Chen, Yuji; Pang, Jin‐Shu; Guo, Danxia; Wen, Dong‐Yue; Yang, Hong; He, Yun

doi:10.1002/jum.16282

Cited by 5 publications

(11 citation statements)

References 22 publications

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“…The 26 studies comprised a total of 8,495 patients with 9,244 lesions. Of the studies, 17 used SonoVue ® as the CA ( 13 - 29 ), seven used Sonazoid ® ( 30 - 36 ), and two used both SonoVue ® and Sonazoid ® ( 37 , 38 ). Three studies were prospective ( 13 , 19 , 38 ) and 23 were retrospective ( 14 - 18 , 20 - 37 ).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies were prospective ( 13 , 19 , 38 ) and 23 were retrospective ( 14 - 18 , 20 - 37 ). Of the studies, 10 used histopathology only as the reference standard ( 15 , 16 , 19 , 21 , 23 - 25 , 27 , 30 , 33 ) and 16 used both histopathology and imaging follow-up as the reference standard ( 13 , 14 , 17 , 18 , 20 , 22 , 26 , 28 , 29 , 31 , 32 , 34 - 38 ).…”

Section: Resultsmentioning

confidence: 99%

“…One of the nine studies using Sonazoid ® as the CA evaluated the diagnostic performance of Sonazoid ® using the ACR LR-5 criteria and thus was not included in the further analysis. Eight studies with 1,128 nodules examined the diagnostic efficiency of Sonazoid ® modified LR-5 ( 30 - 37 ), of which, two used version 1 and six used version 2. The detailed criteria of SonoVue ® LR-5 and Sonazoid ® modified LR-5 are set out in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…In terms of the LR-M algorithms, 15 studies ( 13 - 17 , 20 - 28 , 38 ) examined the diagnostic performance of ACR LR-M of SonoVue ® . However, only three studies ( 30 , 34 , 35 ) examined the diagnostic performance of the modified LR-M in diagnosing non-HCC malignancies, and reported 457 HCCs, 45 non-HCC malignancies, and 46 benign lesions.…”

Section: Resultsmentioning

confidence: 99%

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Compared with SonoVue® LR-5, Sonazoid® modified LR-5 has better diagnostic sensitivity for hepatocellular carcinoma: a systematic review and meta-analysis

Cao,

Wang,

Ling

2024

Quant Imaging Med Surg

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Background The contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) is a standardized system for reporting liver nodules in patients at risk of developing hepatocellular carcinoma (HCC) and is only recommended for pure blood pool agents such as SonoVue ® . A modified LI-RADS was proposed for Sonazoid ® , a Kupffer cell-specific contrast agent. This meta-analysis was conducted to compare the diagnostic efficiency of the CEUS LI-RADS for SonoVue ® and the modified LI-RADS for Sonazoid ® . Methods The PubMed, Medline, Web of Science, Embase, and Cochrane Library databases were systematically searched to retrieve studies on the diagnostic efficiency of the CEUS LI-RADS algorithms in diagnosing HCC using SonoVue ® and/or Sonazoid ® from January 2016 to June 2023. Histopathology or imaging follow-up served as the reference standards. Only articles published in English on retrospective or prospective studies with full reports were included in the meta-analysis. A bivariate random-effects model was used. Data pooling, meta-regression, and sensitivity analysis were performed for the meta-analysis. Deeks’ funnel plot asymmetry test was used to evaluate publication bias, and the QUADAS-2 tool was used to assess the methodological quality of eligible studies. Results In total, 26 studies comprising 8,495 patients with 9,244 lesions were included in the meta-analysis. The pooled data results for SonoVue ® LI-RADS category 5 (LR-5) and Sonazoid ® modified LR-5 were as follows: pooled sensitivity: 0.68 [95% confidence interval (CI): 0.64–0.73, I 2 =89.20%; P<0.01] and 0.82 (95% CI: 0.74–0.87, I 2 =85.39%; P<0.01) (P<0.05); pooled specificity: 0.93 (95% CI: 0.90–0.96, I 2 =86.52%; P<0.01) and 0.86 (95% CI: 0.79–0.91, I 2 =59.91%; P=0.01) (P<0.05); pooled area under the curve (AUC): 0.86 (95% CI: 0.82–0.89) and 0.91 (95% CI: 0.88–0.93) (P<0.05), respectively. The meta-regression analysis revealed that the study design, subject enrollment method, and reference standard contributed to the heterogeneity of SonoVue ® LR-5, and the number of lesions was a source of heterogeneity for Sonazoid ® modified LR-5. The diagnostic performance of the LI-RADS category M (LR-M) algorithms of SonoVue ® and Sonazoid ® was comparable. Conclusions The Sonazoid ® modified LR-5 algorithm had a higher diagnostic sensitivity, lower specificity, and higher AUC than SonoVue ® LR-5.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Compared with SonoVue® LR-5, Sonazoid® modified LR-5 has better diagnostic sensitivity for hepatocellular carcinoma: a systematic review and meta-analysis

Cao,

Wang,

Ling

2024

Quant Imaging Med Surg

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“…The modified algorithm integrates the unique KP characteristics of Sonazoid, but whether it should be more widely applied needs to be confirmed with additional research. Some studies have demonstrated that the two algorithms provide a highly similar diagnostic performance ( 15 , 16 ), while others have indicated that the modified algorithm has superiority in diagnostic sensitivity ( 14 , 17 , 18 ). However, thus far, no meta-analysis comparing the two algorithms of Sonazoid for diagnosing HCC has been conducted.…”

Section: Introductionmentioning

confidence: 99%

The American College of Radiology contrast-enhanced ultrasound Liver Imaging Reporting and Data System and its modified version in diagnosing hepatocellular carcinoma via Sonazoid: a meta-analysis

Cao,

Wang,

Ruan

et al. 2024

Quant Imaging Med Surg

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Background The American College of Radiology (ACR) developed the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) for pure blood contrast agents, but Sonazoid was not included. Modifications to LI-RADS have been proposed for Sonazoid. The purpose of this meta-analysis was to identify and compare the diagnostic efficacy of the two LI-RADS algorithms of Sonazoid. Methods We searched the PubMed, MEDLINE, Web of Science, Embase, and Cochrane Library databases from databases inception to August 31, 2023, to find original studies on the ACR LI-RADS and/or modified LI-RADS algorithm with Sonazoid used as the contrast agent in patients with high-risk hepatocellular carcinoma (HCC). A bivariate random-effects model was used. Data pooling, meta-regression, and sensitivity analysis were performed for meta-analysis. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to assess the methodological quality, and the Deeks funnel plot asymmetry test was used to evaluate the publication bias. Results A meta-analysis of 10 studies with 1,611 observations was conducted. The pooled data for ACR LI-RADS category 5 (LR-5) and modified LR-5 were respectively as follows: pooled sensitivity, 0.70 [95% confidence interval (CI): 0.64–0.75] and 0.81 (95% CI: 0.76–0.86) (P<0.05); pooled specificity, 0.90 (95% CI: 0.82–0.94) and 0.87 (95% CI: 0.81–0.91) (P>0.05); and pooled area under the summary receiver operating characteristic curve, 0.84 and 0.91. The diagnostic performance of LI-RADS category M (LR-M) of the two algorithms was comparable. Study heterogeneity was observed. Conclusions The results indicated that modified LR-5 algorithm demonstrated improved diagnostic sensitivity compared with the ACR LR-5 algorithm of Sonazoid, with differences observed between the different versions. Further research is needed to validate and explore the optimal diagnostic criteria for HCC using Sonazoid. Before the database search was conducted, this study was registered on PROSPERO (International Prospective Register of Systematic Reviews; CRD42023455220).

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Diagnostic Test Accuracy of Contrast‐Enhanced Ultrasound With Sonazoid for Assessment of Focal Liver Lesions: A Systematic Review and Meta‐Analysis

Tang,

Sasaki,

Hawley

et al. 2024

J of Clinical Ultrasound

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This meta‐analysis examined the diagnostic accuracy of Sonazoid‐enhanced ultrasonography (SZ‐CEUS) in discriminating malignant from benign focal liver lesions (FLLs) and HCC from non‐HCC FLLs. Finding relevant studies required a rigorous PubMed, EMBASE, and other database search. To distinguish malignant from benign FLLs, SZ‐CEUS had a pooled sensitivity of 94% (95% CI: 0.91–0.95) and specificity of 84% (95%: 0.78–0.89). HCC distinction had 83% sensitivity and 96% specificity (95% CI: 0.80–0.85 and 0.95–0.97). SZ‐CEUS accurately distinguishes malignant from benign FLLs and HCC from non‐HCC lesions, especially smaller HCC lesions.

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Comparison of the Feasibility and Diagnostic Performance of ACR CEUS LI‐RADS and a Modified CEUS LI‐RADS for HCC in Examinations Using Sonazoid

Cited by 5 publications

References 22 publications

Compared with SonoVue® LR-5, Sonazoid® modified LR-5 has better diagnostic sensitivity for hepatocellular carcinoma: a systematic review and meta-analysis

Compared with SonoVue® LR-5, Sonazoid® modified LR-5 has better diagnostic sensitivity for hepatocellular carcinoma: a systematic review and meta-analysis

The American College of Radiology contrast-enhanced ultrasound Liver Imaging Reporting and Data System and its modified version in diagnosing hepatocellular carcinoma via Sonazoid: a meta-analysis

Diagnostic Test Accuracy of Contrast‐Enhanced Ultrasound With Sonazoid for Assessment of Focal Liver Lesions: A Systematic Review and Meta‐Analysis

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