Discrimination between neoplastic and non-neoplastic lesions in cirrhotic liver using contrast-enhanced ultrasound

Xu, Hongwei; Lu, M-D; Liu, L-N; Yf, Zhang; Guo, L-H; Xu, Jinwei; Liu, C

doi:10.1259/bjr/19932596

Cited by 37 publications

(24 citation statements)

References 48 publications

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“…This is more frequent in patients in Eastern countries, because washout is found in 80.4% of HCC cases in the portal phase and in 95.3% of HCC cases in the late phase [17,18] . However, in those 1-2 cm, only 53.5% exhibited washout in the portal phase and 69%-90.7% in the late phase [19,24] . Washout is observed more frequently and quickly in HCC with poorer grades of differentiation than in well-differentiated HCC, which tend to be iso-enhanced in the late phase [25][26][27] .…”

Section: Characterization Of Hcc By Ceusmentioning

confidence: 90%

“…In general, the sensitivity, specificity, and PPV of CEUS in diagnosing HCC are 88.8%, 89.2% and 91.3%, respectively [18] . The diagnostic ability is highly associated with the nodular size; the sensitivities in nodules 1.0-2.0, 2.1-3.0 and 3.1-5.0 cm are 69%-80%, 97% and 100%, respectively, and the accuracies are 82%-87%, 97% and 100%, respectively [17,19,24] . The 2005 American Association for the Study of Liver Diseases (AASLD) guidelines has accepted CEUS as a reference imaging for the diagnosis of HCC just like contrast-enhanced CT or MRI [6] .…”

Section: Characterization Of Hcc By Ceusmentioning

confidence: 99%

“…Pathologically, large RN and low-grade DN generally show arterial and capillary supply similar to that detected in the adjacent cirrhotic nodules, whereas high-grade DN and HCC may show abnormally increased arterial supply. About 33.3%-60% of high grade DN cases show arterial hyper-enhancement whereas 40%-66.7% show hypoenhancement [21,24] . Washout is seldom found in the late phase for high grade DN, in contrast to typical HCC.…”

Section: Characterization Of Hcc By Ceusmentioning

confidence: 99%

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Management of hepatocellular carcinoma: The role of contrast-enhanced ultrasound

Zheng

Liu

2014

WJR

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Hepatocellular carcinoma (HCC) is the sixth most common neoplasm and the third cause of cancer death worldwide. Contrast enhanced ultrasound (CEUS) has been applied for more than ten years and plays increasingly important roles in the management of HCC. On the basis of the Guideline and Good Clinical Practice Recommendations for CEUS in the liver-update 2012 and related literature about the management of HCC, we summarize the main roles and applications of CEUS in the management of HCC, including HCC surveillance, diagnosis, CEUS-guided treatment, treatment response evaluation and follow-up. The diagnostic algorithm for HCC is also suggested. Meanwhile, the comparisons between CEUS and contrast enhanced computed tomography/magnetic resonance imaging (CECT/CEMRI) in these areas are made. Although CEUS is subject to the same limitation as ordinary US and is inferior to CECT/CEMRI in some aspects, CEUS has proved to be of great value in the management of HCC with inherent advantages, such as sufficient high safety profile making it suitable for patients with renal failure or allergic to iodine, absence of radiation, easy reproducibility and high temporal resolution. The tremendous application of CEUS to the diagnosis and treatment of HCC provides more opportunities for patients with HCC diagnosed at different stages.

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Section: Characterization Of Hcc By Ceusmentioning

confidence: 90%

Section: Characterization Of Hcc By Ceusmentioning

confidence: 99%

Section: Characterization Of Hcc By Ceusmentioning

confidence: 99%

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Management of hepatocellular carcinoma: The role of contrast-enhanced ultrasound

Zheng

Liu

2014

WJR

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“…Indeed, the HCC pattern is not always typical in small lesions. The discrimination between neoplastic and non-neoplastic lesions on a cirrhotic background was evaluated by Xu et al [26], who analysed 225 consecutive patients during a US imaging surveillance program. Based on the typical enhancement pattern, the accuracy of CEUS was 91%, with a PPV of 100% and a negative predictive value (NPV) of 70.5%, respectively.…”

Section: Recent Reports About the Diagnostic Accuracy Of Ceus In Focamentioning

confidence: 99%

Imaging Diagnosis of Hepatocellular Carcinoma: Recent Advances of Contrast-Enhanced Ultrasonography with SonoVue®

et al. 2015

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Due to the ability to detect the typical contrast-imaging pattern for hepatocellular carcinoma (HCC), that is hyperenhancement in the arterial phase and hypoenhancement in the late phase on a cirrhotic background, contrast-enhanced ultrasonography (CEUS) was included in the American diagnostic algorithm for HCC in 2005. However, its role has been questioned because of the possibility of misdiagnosis of cholangiocarcinoma. The present review aims to describe the advantages and disadvantages of CEUS applications using Sonovue® for HCC. In particular there is focus on the accuracy of CEUS in detecting the typical HCC pattern, the CEUS patterns of intrahepatic cholangiocarcinoma (ICC), the risk of misdiagnosis with HCC, the diagnostic use of CEUS in cases of locoregional and systemic treatments, and the evaluation of response to antiangiogenic treatment using dedicated software.

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“…Ultrasonography (US) is generally used as a first-line imaging tool to distinguish FLLs. Currently, non-invasive methods such as US, especially contrast-enhanced ultrasound (CEUS), magnetic resonance imaging (MRI), and computed tomography (CT) have been used to detect FLLs and have a highlevel of diagnostic accuracy in assessing the morphology of these lesions [3][4][5][6]. Nonetheless, each of these technologies has its limitations.…”

Section: Introductionmentioning

confidence: 99%

Shear wave elastography imaging for detecting malignant lesions of the liver: a systematic review and pooled meta-analysis

et al. 2017

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Aim: To investigate the clinical utility of shear wave elastography (SWE) imaging in the identification of malignant and benign lesions of the liver lesions by conducting a meta-analysis. Material and methods: The Cochrane library, Embase and Pubmed were searched for relevant studies with publication data through February 2016. Studies evaluating the diagnostic accuracy of SWE in the identification of malignant and benign lesions of the liver using SWE technology were selected. The cytology, histology or clinical imaging was used as the reference standard. The pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio, and the area under hierarchical summary receiver operating characteristic curve (HSROC) were used to examine the diagnostic accuracy. Results: A total of 9 cohort studies involving 1046 liver lesions (malignant 679) from 968 patients were identified. All of the 9 studies were prospective studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of SWE in differentiating malignant and benign liver lesions were 82.2% (95% CI: 73.4–88.5), 80.2% (95% CI: 73.3–85.7), 4.159 (95% CI: 2.899–5.966), 0.222 (95% CI: 0.140–0.352), and 18.749 (95% CI: 8.746–40.195), respectively. The area under the HSROC curve was 87% (95% CI: 84–90). Conclusions: This meta-analysis indicates that SWE is useful in evaluating the stiffness of liver lesions and in differentiating between malignant and benign lesions. Due to the high sensitivity, specificity, and diagnostic odds ratio, SWE can be considered as a useful complement to conventional ultrasonography.

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Discrimination between neoplastic and non-neoplastic lesions in cirrhotic liver using contrast-enhanced ultrasound

Abstract: CEUS improves diagnostic performance in differentiating HCCs from non-neoplastic nodules in cirrhotic patients compared with baseline ultrasound. Diagnosis of HCCs ≤2.0 cm diameter by CEUS is still a clinical concern, and thus needs further investigation.

Cited by 37 publications

References 48 publications

Management of hepatocellular carcinoma: The role of contrast-enhanced ultrasound

Management of hepatocellular carcinoma: The role of contrast-enhanced ultrasound

Imaging Diagnosis of Hepatocellular Carcinoma: Recent Advances of Contrast-Enhanced Ultrasonography with SonoVue®

Shear wave elastography imaging for detecting malignant lesions of the liver: a systematic review and pooled meta-analysis

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