Contrast-enhanced Ultrasound for the Characterization of Focal Liver Lesions – Diagnostic Accuracy in Clinical Practice (DEGUM multicenter trial)

Strobel, D; Seitz, Karlheinz; Blank, Wolfgang; Schüler, Andreas; Dietrich, CF; Herbay, A. von; Friedrich‐Rust, Mireen; Kunze, Georg; Becker, Dirk; Will, Uwe; Kratzer, Wolfgang; Albert, F. W.; Pachmann, C.; Dirks, Klaus; Strunk, H.; Greis, Christian; Bernatik, T.

doi:10.1055/s-2008-1027806

Cited by 279 publications

(274 citation statements)

References 14 publications

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“…132 Newer contrast-enhanced ultrasonography techniques recently have been approved for use in the United States and may increase the diagnostic accuracy of ultrasound for characterizing focal liver lesions. 133 In any patient found to have advanced liver disease or cirrhosis (ie, those with laboratory evidence of liver disease, extrahepatic signs of "portal hypertension," or significant abnormalities on imaging), abdominal imaging by ultrasound or MR is performed every 6 months in conjunction with follow-up by a hepatologist to monitor the development of hepatocellular carcinoma. 134 The combined use of serum liver tumor marker α-fetoprotein (AFP) and ultrasound increases detection rates for HCC in cirrhotic patients without CHD 135 but All patients who underwent heart surgery in or before 1992 should be screened for chronic hepatitis B and C infection.…”

Section: Managementmentioning

confidence: 99%

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Lui¹,

Saïdi²,

Bhatt³

et al. 2017

Circulation

180

136

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ABSTRACT:Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease and its risk factors are becoming increasingly prevalent. Disorders of psychosocial and cognitive development are key factors affecting the quality of life of these individuals. It is incumbent on physicians who care for patients with CHD to be mindful of the effects that disease of organs other than the heart may have on the well-being of adults with CHD. Further research is needed to understand how these noncardiac complications may affect the long-term outcome in these patients and what modifiable factors can be targeted for preventive intervention.

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Section: Managementmentioning

confidence: 99%

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Lui¹,

Saïdi²,

Bhatt³

et al. 2017

Circulation

180

136

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“…By means of contrastenhanced ultrasound (CEUS), the Sp for benign-malignant differentiation and the final diagnosis of a FLL has significantly increased [9][10][11]. The accuracy of CEUS for the final diagnosis of FLL is similar to that of contrast-enhanced CT (90.3% CEUS vs. 87.8% for contrast-enhanced CT) [11,12] and of contrastenhanced MRI [11,13].…”

Section: Introductionmentioning

confidence: 99%

Diffusion Weighted Magnetic Resonance Imaging for the Classification of Focal Liver Lesions as Benign or Malignant

Caraiani

Chiorean

Fenesan

et al. 2015

JGLD

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Background & Aims: To assess the role of diffusion weighted imaging sequence (DWI), routinely used in hepatic magnetic resonance imaging (MRI) for the differentiation of focal liver lesions (FLLs) as benign or malignant. Method: 99 FLLs assessed by liver MRI in 80 patients were included in the present study. All lesions were retrospectively analyzed by two experienced radiologists, independent from each other, who were not aware of the previous results obtained by using different imaging techniques. All included FLLs had a final histological diagnosis or a final diagnosis based on consensus reading by two experienced radiologists and follow-up at 6 months. The FLLs signal was qualitatively appreciated on the b-800 sequences and on the apparent diffusion coefficient (ADC) map. The ADC value of each FLL was measured and the ADC ratio between the ADC value of the assessed FLL and that of the surrounding liver parenchyma were calculated. Results: The mean ADC value for benign FLLs as assessed by the two independent readers was 1.78 x 10¯³ and 1.72 x 10¯³, respectively. The mean ADC value for malignant FLLs was 0.92 x 10¯³ for the first reader and 0.95 x 10¯³ for the second reader. The mean ADC ratio for benign FLLs was 1.91 and 1.85 for the two readers and for malignant FLLs was 0.91 and 0.94, respectively. Using an ADC value lower than 1.024 x 10¯³ offers a specificity of 100% and a sensitivity of 62.5% for the diagnosis of malignant FLLs. The ADC value is an indicator which is less prone to interobserver variability (correlation of 0.919→1). The ADC ratio has, as the analysis of the ROC curve shows, the best predictive value for differentiation between benign and malignant FLLs. Analysis of the signal intensity on the DWI b-800 image alone is of no significance in differentiating benign from malignant FLLs (p>0.05). Conclusions: The ADC value and the ADC ratio assessed on liver DWI are useful diagnostic tools in the differential diagnosis of benign vs. malignant FLLs. Quantitative methods such as calculating the ADC value or ADC ratio have better diagnostic value than the qualitative techniques.

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“…Unfortunately, until now, there has been no systematic report on the CEUS appearance of IP, which needs further study. In routine clinical practice, a definitive and exact differential diagnosis of FLLs with CEUS entire clip is possible only in some types of lesions, whilst the simple categorization of a lesion as benign or malignant can be achieved with extremely high sensitivity (>90 %) and specificity [2], as well as with an accuracy comparable to CT or MRI in most series [23][24][25][26]. Additionally, in typical lesions the 0-1min clip and 1-4min clip could be comparable to the entire clip in diagnosis of FLLs aforementioned.…”

Section: Discussionmentioning

confidence: 99%

Analysis of only 0-1 min clip or 1-4 min Clip for focal liver lesions during contrast-enhanced ultrasonography

Zhang¹,

Yi²,

Ai³

et al. 2016

Trop. J. Pharm Res

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Contrast-enhanced Ultrasound for the Characterization of Focal Liver Lesions – Diagnostic Accuracy in Clinical Practice (DEGUM multicenter trial)

Abstract: Contrast-enhanced ultrasound clearly improves the differential diagnosis of hepatic tumors and is very helpful in clinical practice when B-scan or power Doppler morphological criteria are missing.

Cited by 279 publications

References 14 publications

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Diffusion Weighted Magnetic Resonance Imaging for the Classification of Focal Liver Lesions as Benign or Malignant

Analysis of only 0-1 min clip or 1-4 min Clip for focal liver lesions during contrast-enhanced ultrasonography

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