Evaluation of hepatocellular carcinoma using SonoVue, a second generation ultrasound contrast agent: correlation with cellular differentiation

Nicolau, Carlos; Catalá, Violeta; Vilana, R.; Gilabert, Rosa; Bianchi, Luís; Solé, Manel; Pagés, Mario; Brú, Concepció

doi:10.1007/s00330-004-2298-0

Cited by 193 publications

(152 citation statements)

References 33 publications

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“…CEUS with Sonazoid detects liver malignancy as defects on the sinusoidal phase with a high sensitivity of 95%, specificity of 93%, positive predictive value of 99%, and negative predictive value of 97% [43] . Tumor differentiation was found to be correlated with the pattern of enhancement in the portal and late phases [44] . The timing of HCC becoming hypo-enhanced on CEUS is correlated with tumor cell differentiation; well-differentiated tumors wash out more slowly than poorly differentiated ones [44,45] .…”

Section: F E D C B Amentioning

confidence: 95%

“…Tumor differentiation was found to be correlated with the pattern of enhancement in the portal and late phases [44] . The timing of HCC becoming hypo-enhanced on CEUS is correlated with tumor cell differentiation; well-differentiated tumors wash out more slowly than poorly differentiated ones [44,45] . The micro flow imaging technique was found to be effective in depicting the intra-tumoral vascular architecture which correlated with pathologic differentiation of HCC (Figure 2) [46] .…”

Section: F E D C B Amentioning

confidence: 95%

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Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Wong

Xu²,

Xie³

2009

WJR

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Patients with liver cirrhosis are at increased risk of hepatocellular carcinoma (HCC). Conventional or baseline ultrasound (BUS) is often used as the first-line tool for HCC surveillance or detection, but the accuracy of BUS in HCC detection or differentiation from other focal liver lesions (FLLs) is limited. Contrast-enhanced ultrasound (CEUS) represents a recent revolution in the field of ultrasonography and it has become increasingly important in the detection and evaluation of FLLs. In CEUS, HCC typically exhibits arterial hyper-enhancement and portal-venous washout represented by hypoenhanced lesions in the portal venous and late phases. The detection rate of HCC was significantly higher with CEUS compared with BUS. Even regenerative or some dysplastic nodules may exhibit arterial hyperenhancement as they are differentiated from HCC by its iso-enhancing pattern in portal and late phases. The contrast-enhancement patterns of other different types of benign and malignant FLLs, as well as their detection rates with CEUS, were also discussed.

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Section: F E D C B Amentioning

confidence: 95%

Section: F E D C B Amentioning

confidence: 95%

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Wong

Xu²,

Xie³

2009

WJR

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“…Contrast-enhanced ultrasound has meanwhile been evaluated for numerous organs and has been proven to have a clear role in the detection and differential diagnosis of liver lesions [7][8][9][10][11][12][13][14][15] . For this, low-MI imaging is the technique of choice since it allows the liver to be scanned in the usual way.…”

Section: Contrast-specific Imaging Techniquesmentioning

confidence: 99%

Contrast-enhanced ultrasound for examining tumor biology

Delorme

Krix²

2006

Cancer Imaging

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This paper reviews the potential of ultrasound for assessing the viability and biological behavior of tumors. Unlike color Doppler sonography, modern techniques for contrast-enhanced ultrasound permit the measurement of tissue perfusion irrespective of vessel size or flow velocity. Perfusion can also be assessed quantitatively, using replenishment kinetics or derivates thereof. The perfusion of tumors is a surrogate parameter of their viability and may mirror their response to therapy. Furthermore, the degree of vascularity in a tumor may express its aggressiveness and help to predict its response to treatment. In animal models, a decrease in blood flow has been shown to precede a shrinkage of tumors treated with anti-angiogenic compounds. In liver metastases, arterial and portal blood supply can be assessed separately, and a response to stereotactic radiotherapy was found to go along with a decrease in arterial perfusion. Moreover, a relatively high arterial perfusion of liver metastases may predict a response to chemotherapy. Contrastenhanced ultrasound may be a potent tool for assessing the effects of anti-angiogenic treatment in patients.

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“…However conventional unenhanced gray-scale US is somewhat limited in characterizing focal liver lesions, and several papers have described the general capabilities of contrast-enhanced US (CEUS) in improving focal liver lesion characterization [1][2][3][4][5][6][7][8][9][10][11].…”

mentioning

confidence: 99%

“…1). The late phase, with or without hepato-specificity, was showed to be the most important for focal liver lesions characterization since benign lesions present prevalently a sustained enhancement with hyper or isovascular appearance to the adjacent liver while malignant lesions present prevalently microbubble washout with hypovascular appearance [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] (Fig. 2).…”

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confidence: 99%

The real capabilities of contrast-enhanced ultrasound in the characterization of solid focal liver lesions

Quaia

2010

Eur Radiol

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Contrast-enhanced US (CEUS) using intravenous agents is a rapidly evolving field even though the main clinically recognized application is the characterization of focal liver lesions. Several reports have described the improvement provided by CEUS in the characterization of focal liver lesions in comparison to unenhanced US. CEUS with low transmit power insonation allows the real-time assessment of focal liver lesion contrast enhancement and vascularity during the different dynamic phases after injection of an intravenous contrast agent. CEUS allows the accurate characterization of focal liver lesions as benign or malignant based on the lesion contrast enhancement pattern during the arterial phase and lesion vascularity during portal-late phase in comparison to the adjacent liver parenchyma. During the portal-late phase, benign lesions present prevalently a sustained contrast enhancement with hyper or isovascular appearance to the adjacent liver while malignant lesions present prevalently microbubble washout with hypovascular appearance. On the other hand, the histology of focal liver lesions can only be confidently predicted in selected cases by CEUS, as in liver haemangiomas presenting typical nodular peripheral enhancement with subsequent centripetal fill-in and focal nodular hyperplasia with central spoke wheelshaped contrast enhancement.Grey-scale ultrasound (US) is the most widespread imaging procedure for investigating the liver parenchyma due to its relative low cost, availability, safety, and high patient acceptance. However conventional unenhanced gray-scale US is somewhat limited in characterizing focal liver lesions, and several papers have described the general capabilities of contrast-enhanced US (CEUS) in improving focal liver lesion characterization [1][2][3][4][5][6][7][8][9][10][11].Recently, European Radiology has published several papers regarding the capabilities of CEUS in focal liver lesion characterization [12][13][14][15][16]. Soussan et al. [16] presented an interesting study evaluating the role of CEUS in the characterization of solid focal liver lesions in comparison to contrast-enhanced MR imaging. In this study authors analysed a series of 47 patients with 50 incidental focal liver lesions-24 focal nodular hyperplasias (FNHs), 11 hepatocellar adenomas, 10 haemangiomas, 1 focal fatty changes, and 4 malignancies including 2 hepatocellular adenomas with malignant foci, 1 hepatocellular carcinoma (HCC), and 1 epithelioid haemangioendotheliomadetected by US and scheduled for contrast-enhanced MR imaging. All patients underwent CEUS after intravenous injection of an US contrast agent consisting of sulphur hexafluoride-filled microbubbles (SonoVue, Bracco, Italy). The MR images and CEUS cine-clips of each lesion were randomly assigned to two blinded readers, with 17 and 22 years of experience in MR imaging and 8 years of experience in CEUS, who independently reviewed all the examinations and were asked to provide the most likely histological diagnosis for each focal liver lesion a...

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Evaluation of hepatocellular carcinoma using SonoVue, a second generation ultrasound contrast agent: correlation with cellular differentiation

Cited by 193 publications

References 33 publications

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Detection of focal liver lesions in cirrhotic liver using contrast-enhanced ultrasound

Contrast-enhanced ultrasound for examining tumor biology

The real capabilities of contrast-enhanced ultrasound in the characterization of solid focal liver lesions

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