Harmonic Hepatic US with Microbubble Contrast Agent: Initial Experience Showing Improved Characterization of Hemangioma, Hepatocellular Carcinoma, and Metastasis

Wilson, Stephanie R.; Burns, Peter N.; Muradali, Derek; Wilson, Jessica A.; Lai, Xiaoming

doi:10.1148/radiology.215.1.r00ap08153

Cited by 311 publications

(179 citation statements)

References 9 publications

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“…258,259,261 The technology of ultrasound diagnosis is evolving rapidly; it is anticipated that advances such as microbubble contrast enhancement and harmonic imaging techniques will significantly improve early detection rates in coming years. [263][264][265][266] There is also a possibility that these developments will raise false-positive findings.…”

Section: Ultrasonographymentioning

confidence: 99%

Surveillance of cirrhosis for hepatocellular carcinoma: systematic review and economic analysis

Coon¹,

Rogers²,

Hewson³

et al. 2007

Health Technol Assess

152

108

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. Declared competing interests of authors: K Stein received an unrestricted grant from Schering Plough (UK) to carry out work on the cost-effectiveness of combination therapy for hepatitis C in 2000. KS is also a member of the editorial board for Health Technology Assessment, but he was not involved in the editorial process for this report. M Cramp sits on hepatitis C advisory boards for Schering Plough, Gilead and Roche. He has received unrestricted educational grants from Roche and Schering Plough to support research and service development. He has been awarded an NHS R&D grant looking at injecting drug users who do not have hepatitis C virus infection. J Thompson Coon received a grant from the Hepatitis C Trust to conduct a systematic review of complementary and alternative therapies for the treatment of chronic hepatitis C. HTA Published September 2007This report should be referenced as follows: NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) programme, now part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the costs, effectiveness and broader impact of health technologies for those who use, man...

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Section: Ultrasonographymentioning

confidence: 99%

Surveillance of cirrhosis for hepatocellular carcinoma: systematic review and economic analysis

Coon¹,

Rogers²,

Hewson³

et al. 2007

Health Technol Assess

152

108

View full text Add to dashboard Cite

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“…However, contrast-enhanced color or power Doppler sonography with microbubble agents has shown several limitations, including blooming artifacts of contrast agents and motion artifacts by cardiac pulsation. 6,[22][23][24][25] Some recent studies have reported that interval delay imaging using a pulse inversion harmonic technique is superior to conventional Doppler sonography for assessing tumor vascularity, 11,12,26 but despite these recent applications of intermittent imaging, most radiologists prefer to scan in a continuous mode.…”

Section: A B C D E Fmentioning

confidence: 99%

Evaluation of Hepatic Focal Nodular Hyperplasia With Contrast-Enhanced Gray Scale Harmonic Sonography

Kim

Lim

Kim

et al. 2004

Journal of Ultrasound in Medicine

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Objective. To assess the potential of contrast-enhanced gray scale harmonic sonography in the evaluation of the typical vascular and enhancement patterns of hepatic focal nodular hyperplasia. Methods. Thirteen patients with 13 lesions of hepatic focal nodular hyperplasia underwent contrastenhanced gray scale harmonic sonography. After the injection of a microbubble contrast agent (SH U 508A), gray scale harmonic sonographic studies using a Coded Harmonic Angio technique were performed with a combination of a period of continuous scanning to assess the vascular pattern (vascular imaging) and interval delay scanning to determine the sequential enhancement pattern (acoustic emission imaging). Each imaging pattern was categorized and analyzed by consensus of 2 experienced radiologists. Results. In 12 (92%) of 13 lesions, vascular imaging during the arterial phase showed central arteries of a spoked wheel pattern, whereas the remaining lesion had stippled vascularity. On acoustic emission imaging, 11 (85%) of 13 lesions were hyperechoic during the early phase, and the remaining 2 (15%) were isoechoic compared with surrounding parenchyma. Ten (77%) of 13 lesions remained either hyperechoic (5 of 13) or isoechoic (5 of 13) during the delay phase, whereas the remaining 3 lesions (23%) were hypoechoic. Conclusions. Contrast-enhanced gray scale harmonic sonography showed the typical vascularity of a spoked wheel pattern during the vascular phase and persistent enhancement on serial acoustic emission imaging in most cases of hepatic focal nodular hyperplasia, and thereby it can be a promising technique in noninvasive diagnosis of this entity.

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“…In addition, coupling conventional color Doppler with a US contrast medium allows only the macrovasculature of the lesions to be displayed because with continuous insonation the bubbles are continuously destroyed in larger vessels and thus never reach the smaller downstream vessels. 4 If the aim of the study by Fracanzani et al was especially to differentiate hepatocellular carcinomas from either atypical or benign nodules by showing subtle differences in microvasculature, then the method used by Fracanzani et al is clearly too rough and inaccurate.…”

Section: Liver Nodule and Us Medium Contrast Agents: Past And Futurementioning

confidence: 99%

“…[3][4][5] The new strategies for tissue characterization of liver nodules (in either a normal or cirrhotic liver) entails the combination of wide-band harmonic imaging, US contrast agents at high and low mechanical index, and different scanning techniques (e.g., intermittent imaging, pulse inversion).…”

Section: Liver Nodule and Us Medium Contrast Agents: Past And Futurementioning

confidence: 99%

“…[3][4][5] On the other hand, intermittent transmission of the ultrasound beam (intermittent harmonic imaging) allows a high mechanical index contrast agent (such as Levovist) to be visualized in small vessels, [3][4][5] whereas to image the contrast agent in blood vessels without destroying the bubbles a low mechanical index contrast agent (the second generation of contrast agents made of microbubbles containing gas different from air) must be used, which reduces the sensitivity of the image but allows a real-time evaluation of the different vascular phases of the contrast medium through the lesion. 4,5 The final aim of these efforts is to display, possibly in real-time and at acceptable costs, the microcirculatory kinetic characteristics of space-occupying liver lesions that are more informative about their nature and compete with the current available contrast-enhanced images of computed tomography and magnetic resonance.…”

Section: Liver Nodule and Us Medium Contrast Agents: Past And Futurementioning

confidence: 99%

See 1 more Smart Citation

Liver nodule and US medium contrast agents: Past and future

Francica¹,

Giorgio²

2002

Hepatology

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Harmonic Hepatic US with Microbubble Contrast Agent: Initial Experience Showing Improved Characterization of Hemangioma, Hepatocellular Carcinoma, and Metastasis

Abstract: Contrast-enhanced harmonic imaging appears superior to conventional Doppler US for hepatic mass characterization. Low-MI continuous and high-MI interval-delay imaging can help assess tumor vascular pattern and microvascular volume.

Cited by 311 publications

References 9 publications

Surveillance of cirrhosis for hepatocellular carcinoma: systematic review and economic analysis

Surveillance of cirrhosis for hepatocellular carcinoma: systematic review and economic analysis

Evaluation of Hepatic Focal Nodular Hyperplasia With Contrast-Enhanced Gray Scale Harmonic Sonography

Liver nodule and US medium contrast agents: Past and future

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