Diagnostic accuracy and interobserver variability of Dynamic Vascular Pattern (DVP) in primary liver malignancies – A simple semiquantitative tool for the analysis of contrast enhancement patterns

Schellhaas, Barbara; Waldner, Maximilian J.; Görtz, RS; Vitali, Francesco; Kielisch, Ch.; Pfeifer, Lukas; Strobel, D; Janka, Rolf; Neurath, Markus F.; Wildner, D

doi:10.3233/ch-16238

Cited by 14 publications

(4 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In recent years, the development of CEUS has attracted scientific interest as a method of more objective and possibly more sensitive assessment of focal liver lesions perfusion and characterization [40][41][42][43][44][45][46][47].…”

Section: Discussionmentioning

confidence: 99%

Multiparametric Dynamic Ultrasound Approach for Differential Diagnosis of Primary Liver Tumors

Ainora

Cerrito

Liguori

et al. 2023

IJMS

View full text Add to dashboard Cite

A correct differentiation between hepatocellular carcinoma (HCC) and intracellular cholangiocarcinoma (ICC) is essential for clinical management and prognostic prediction. However, non-invasive differential diagnosis between HCC and ICC remains highly challenging. Dynamic contrast-enhanced ultrasound (D-CEUS) with standardized software is a valuable tool in the diagnostic approach to focal liver lesions and could improve accuracy in the evaluation of tumor perfusion. Moreover, the measurement of tissue stiffness could add more information concerning tumoral environment. To explore the diagnostic performance of multiparametric ultrasound (MP-US) in differentiating ICC from HCC. Our secondary aim was to develop an US score for distinguishing ICC and HCC. Between January 2021 and September 2022 consecutive patients with histologically confirmed HCC and ICC were enrolled in this prospective monocentric study. A complete US evaluation including B mode, D-CEUS and shear wave elastography (SWE) was performed in all patients and the corresponding features were compared between the tumor entities. For better inter-individual comparability, the blood volume-related D-CEUS parameters were analyzed as a ratio between lesions and surrounding liver parenchyma. Univariate and multivariate regression analysis was performed to select the most useful independent variables for the differential diagnosis between HCC and ICC and to establish an US score for non-invasive diagnosis. Finally, the diagnostic performance of the score was evaluated by receiver operating characteristic (ROC) curve analysis. A total of 82 patients (mean age ± SD, 68 ± 11 years, 55 men) were enrolled, including 44 ICC and 38 HCC. No statistically significant differences in basal US features were found between HCC and ICC. Concerning D-CEUS, blood volume parameters (peak intensity, PE; area under the curve, AUC; and wash-in rate, WiR) showed significantly higher values in the HCC group, but PE was the only independent feature associated with HCC diagnosis at multivariate analysis (p = 0.02). The other two independent predictors of histological diagnosis were liver cirrhosis (p < 0.01) and SWE (p = 0.01). A score based on those variables was highly accurate for the differential diagnosis of primary liver tumors, with an area under the ROC curve of 0.836 and the optimal cut-off values of 0.81 and 0.20 to rule in or rule out ICC respectively. MP-US seems to be a useful tool for non-invasive discrimination between ICC and HCC and could prevent the need for liver biopsy at least in a subgroup of patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Multiparametric Dynamic Ultrasound Approach for Differential Diagnosis of Primary Liver Tumors

Ainora

Cerrito

Liguori

et al. 2023

IJMS

View full text Add to dashboard Cite

show abstract

Section: This Issue Of Clinical Hemorheology and Microcirculation Is mentioning

confidence: 99%

“…These two articles showed the benefit of CEUS in the treatment control for ablation of solid nodules in various organs in terms of the virtues of CEUS such as real-time scanning, easy performance, and immediate assessment. In addition to qualitative evaluation for characterization [4,5], quantitative evaluation of blood flow perfusion is also available with use of CEUS [6]. Other important applications are the assessment of vascular diseases such as vascular complications after liver transplantation or the detection of endoleaks after endovascular aortic repair (EVAR) [7,8] or post-operative complications [9].…”

Section: This Issue Of Clinical Hemorheology and Microcirculation Is mentioning

confidence: 99%

“…Further, the purely intravascular microbubbles enable ultrasound to be used to monitor changes in the blood flow of tumors and in inflamed areas in a diagnostic approach but also for therapy control. Its performance without any requirement for ionizing radiation and with no nephrotoxicity makes it a compelling choice in many clinical arenas and is now FDA approved for liver imaging, and also for children [1][2][3][4][5][6][7][8].In this special issue, a first study evaluated factors which are associated with the initial incomplete ablation in radiofrequency ablation (RFA) for thyroid nodules [2]. Recent intraoperative studies reported the results of CEUS for immediate assessment of ablation status after RFA of hepatic malignancies [3].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Developments in the application of high resolution ultrasound in clinical diagnostics

Jung

2017

View full text Add to dashboard Cite

This issue of Clinical Hemorheology and Microcirculation is dedicated to the developments in the application of high resolution ultrasound in clinical diagnostics.The editors sought to provide information on the latest procedures for ultrasound bringing together outstanding original articles and reviews about new diagnostic information obtained by recent technological advances but also clarify well-established or controversial subjects. A very important step forward in ultrasound technology towards clinical application was the introduction of microbubbles as contrast enhancer. Contrast enhanced ultrasound (CEUS), performed with the intravenous injection of microbubble contrast agents applying the low mechanical index (MI) technique of contrast harmonic imaging has expanded the horizon for ultrasound imaging. CEUS provides a technique with superb sensitivity from early arterial phase up to late venous enhancement in dynamic realtime vascular imaging. For the first time, this ultrasound technology allows the non-invasive demonstration of blood flow of inner organs at a microcirculatory level [1,2]. Further, the purely intravascular microbubbles enable ultrasound to be used to monitor changes in the blood flow of tumors and in inflamed areas in a diagnostic approach but also for therapy control. Its performance without any requirement for ionizing radiation and with no nephrotoxicity makes it a compelling choice in many clinical arenas and is now FDA approved for liver imaging, and also for children [1][2][3][4][5][6][7][8].In this special issue, a first study evaluated factors which are associated with the initial incomplete ablation in radiofrequency ablation (RFA) for thyroid nodules [2]. Recent intraoperative studies reported the results of CEUS for immediate assessment of ablation status after RFA of hepatic malignancies [3]. These two articles showed the benefit of CEUS in the treatment control for ablation of solid nodules in various organs in terms of the virtues of CEUS such as real-time scanning, easy performance, and immediate assessment. In addition to qualitative evaluation for characterization [4,5], quantitative evaluation of blood flow perfusion is also available with use of CEUS [6]. Other important applications are the assessment of vascular diseases such as vascular complications after liver transplantation or the detection of endoleaks after endovascular aortic repair (EVAR) [7,8] or post-operative complications [9].

show abstract

Clinical and Contrast-enhanced Ultrasound Characteristics of Epithelioid and Classic Hepatic Angiomyolipoma: Comparison With Alpha-fetoprotein–negative Hepatocellular Carcinoma

Zou

Huang

Zou

et al. 2021

Ultrasound in Medicine & Biology

View full text Add to dashboard Cite

Diagnostic accuracy and interobserver variability of Dynamic Vascular Pattern (DVP) in primary liver malignancies – A simple semiquantitative tool for the analysis of contrast enhancement patterns

Abstract: Although developed to improve diagnostic accuracy and objectivity in the assessment of focal liver lesions, DVP alone seems insufficient for differential diagnosis of HCC, ICC and FNH and cannot replace the skills of an experienced observer.

Cited by 14 publications

References 45 publications

Multiparametric Dynamic Ultrasound Approach for Differential Diagnosis of Primary Liver Tumors

Multiparametric Dynamic Ultrasound Approach for Differential Diagnosis of Primary Liver Tumors

Developments in the application of high resolution ultrasound in clinical diagnostics

Clinical and Contrast-enhanced Ultrasound Characteristics of Epithelioid and Classic Hepatic Angiomyolipoma: Comparison With Alpha-fetoprotein–negative Hepatocellular Carcinoma

Contact Info

Product

Resources

About