Focal masses in a non-cirrhotic liver: The additional benefit of CEUS over baseline imaging

Chiorean, Liliana; Cantisani, Vito; Jenssen, Christian; Sidhu, Paul S.; Baum, Ulrich; Dietrich, Christoph F.

doi:10.1016/j.ejrad.2015.05.007

Cited by 28 publications

(24 citation statements)

References 61 publications

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“…The widespread use of imaging techniques, such as ultrasound (US), computed-tomography (CT) and magnetic resonance imaging (MRI) has led to a constantly increasing detection and diagnosis of FLLs in completely asymptomatic patients [1][2][3][4]. The frequency of incidentally detected FLLs varies in the literature between 7.2% and 33% for CT, 10.2% and 34.5% for MRI, and between 2.3% and 6.2% for screening US [5].…”

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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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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“…According to the EFSUMB guideline, CEUS allows the characterization of most of FLLs by analysing the enhancement pattern during the arterial, portal venous and late phases [2,4,5,13]. Previous studies have shown that transabdominal CEUS with low frequency convex transducer is significantly better than unenhanced BMUS for the detection [1,3] and classification [7,10,33] of FLLs. For unclear small FLLs which could not be characterized with confidence by using transabdominal BMUS or Doppler ultrasound techniques, real-time CEUS has demonstrated the ability to characterize them reliably [1,12,21].…”

Section: Discussionmentioning

confidence: 99%

“…Detection of small FLLs of less than 5 mm always is challenging as these lesions often appear isoechoic on B mode ultrasound (BMUS); the same is true for superficial FLLs close to the liver capsule [6]. Over the last decade, with the wide clinical application of microbubble ultrasound contrast agents, contrastenhanced ultrasound (CEUS) has noticeably improved the identification and characterization of FLLs, especially for FLLs less than 10 mm in size [7][8][9][10][11][12]. However, it still proves to be difficult to differentiate malignant and benign FLLs, especially when the lesion is smaller than 10 mm or located superficially [2,13].…”

Section: Introductionmentioning

confidence: 99%

Detection and characterization of small superficially located focal liver lesions by contrast-enhanced ultrasound with high frequency transducers

Wang¹,

Dong²,

Cao³

et al. 2017

Med Ultrason

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Aim: To evaluate the benefits of contrast-enhanced ultrasound (CEUS) with high frequency transducers in the detection and characterization of small superficially located focal liver lesions (FLLs).Material and methods: From January 2015 to October 2016, 27 superficial FLLs detected by MRI were examined, first with the low frequency convex transducer (1-5 MHz) and afterwards with a high frequency transducer (7.5-12 MHz). High frequency dynamic CEUS was performed after a bolus injection of 2.4 ml SonoVue®. FLLs were confirmed by histopathology after surgery (n=18) or ultrasound guided 18-gauge core-needle biopsy (n=8), or by MRI follow-up (n =1).Results: The mean diameter of FLLs was 10.5±3.1 mm, and meandepth was 6.2±5.3 mm. While using a high frequency transducerthe detection rate of FLLs (100%, 27/27) was significantly higher than low frequency transducer (25.9%, 7/27) (p<0.05). The overall sensitivity, specificity and diagnostic accuracy were significantly improved by CEUS with a high frequency transducer (sensitivity 88.9%; specificity 92.6%; accuracy 96.2%).Conclusion: Combining CEUS with the performance of high-frequency transducers is a promising technique to improve the detection and accurate diagnosis of small and superficial FLLs appearing indistinctive on BMUS.

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“…컴퓨터를 활용한 영상처리 기술이 발전하면서 이를 이용 하여 초음파 진단의 성능을 개선하고자 하는 연구가 최근 들어 다양하게 시도되고 있다 [1,2]. 예컨대 영상에서 조영증 간 병변 진단의 위한 4가지 유형의 픽셀분류 영상에 적용하 는 에너지 함수는 Equation (7)과 같이 정의된다.…”

Section: 서 론1 )unclassified

Parametric Image Generation and Enhancement in Contrast-Enhanced Ultrasonography

Kim¹,

Lee²,

Jo³

et al. 2017

KIPS Transactions on Software and Data Engineering

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This paper proposes image processing techniques that improve usability and performance in a diagnostic system of the contrastenhanced ultrasonography. For a methodology for visualizing diagnostic parameter data in an ultrasonic medical image, an expression of transition time data with successive pixel values and a method of generating a lesion diagnostic parameter image with four categorized values are presented. We also introduce a MRF-based image enhancement technique to eliminate noises from generated parametric images. Such parametric image generation technique can overcome the difficulty of discriminating dynamic change in patterns in the ultrasonography. The technique clarifies the contour of the region in the original image and facilitates visual determination of the characteristics of the lesion through four colors. With regard to this MRF-based image enhancement, we define the energy function of consecutive pixel values and develop a technique to optimize it, and the usability of the proposed theory is examined through experiments with medical images.

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Focal masses in a non-cirrhotic liver: The additional benefit of CEUS over baseline imaging

Cited by 28 publications

References 61 publications

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

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

Detection and characterization of small superficially located focal liver lesions by contrast-enhanced ultrasound with high frequency transducers

Parametric Image Generation and Enhancement in Contrast-Enhanced Ultrasonography

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