The Role of Contrast-Enhanced Sonography of Focal Liver Lesions Before Percutaneous Biopsy

Wu, Wei; Chen, Minhua; Yin, Shanshan; Yan, Kun; Fan, Zhihui; Yang, Wei; Dai, Ying; Huo, Ling; Li, Jiyou

doi:10.2214/ajr.05.0535

Cited by 92 publications

(74 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Tumor tissue, identified by the presence of vascularity, can be reliably visualized under CEUS. CEUS-guided biopsy increases the diagnostic rate by 10% and decreases the false negative rate, particularly in large tumors with areas of necrosis (10,12,15).…”

mentioning

confidence: 99%

Contrast-enhanced US-guided percutaneous biopsy of anterior mediastinal lesions

Mao²,

Ping³

et al. 2017

Diagn Interv Radiol

View full text Add to dashboard Cite

A nterior mediastinal tumors are common in clinical settings. Common lesions include inflammatory vs. neoplastic lesions, benign vs. malignant lesions, and primary vs. metastatic lesions. Among these, lymphomas are medically treatable, thymomas are surgically treatable, and metastatic carcinomas are nonresectable (1). Primary mediastinal tumors represent only about 3% of the tumors within the chest wall. Metastatic carcinoma and non-Hodgkin's lymphoma are among common anterior mediastinal tumors. The rates of nonsurgical tumors such as lymphoma are higher than the rates of surgical diseases such as thymomas (2). Some anterior mediastinal tumors such as nonseminomatous germ cell tumors, thymic carcinomas, seminomas, lymphomas, and thymomas are quite similar in medical imaging appearance, but are quite different in treatment strategy; early and precise histopathologic diagnosis of anterior mediastinal lesions is essential for correct therapeutic decision, and remains an interesting diagnostic challenge (3).Several biopsy techniques and approaches have been previously described and are available to obtain specimens of anterior mediastinal lesions, including percutaneous image-guided core needle biopsy, parasternal anterior mediastinotomy, endoscopic ultrasonography (US)-guided biopsy, video-assisted thoracoscopic surgery, cervical mediastinoscopy, and open surgical procedures (1). Most of those procedures require intubation and general anesthesia. Open biopsy is associated with morbidity, chance of pleural dissemination, and poor long-term results. For these reasons, surgically strategies are not suitable for anterior mediastinum lesions (4).In general, US-guided percutaneous core needle biopsy is the first diagnostic choice because it is a minimally invasive, safe, and cost-effective procedure. I N T E R V E N T I O N A L R A D I O LO G Y O R I G I N A L A R T I C L E PURPOSEWe aimed to explore the value of contrast-enhanced ultrasonography (CEUS) in guidance of percutaneous biopsy of anterior mediastinal lesions. METHODSNinety patients with solitary anterior mediastinal lesions (55 males, 35 females; mean age, 46±4 years) were included. Patients were randomly divided into CEUS group (n=45) and conventional ultrasonography (US) group (n=45). Real-time US-guided core needle (16 G) percutaneous biopsies were performed in all lesions. The display of internal mammary arteries, internal necrosis, and active areas were recorded and compared. Biopsy success rate and diagnostic accuracy were compared between the two groups. RESULTSDisplay rate of unenhanced internal necrosis was higher in the CEUS group than in the US group (88.9% vs. 46.7%, P = 0.041). With real-time CEUS guidance, internal mammary arteries were effectively displayed and avoided during biopsies in 68.9% of the lesions (31/45). Of the lesions, 88.9% (80/90) were histologically proven, including 13 benign lesions and 67 malignancies. There was a significant difference in the rate of successful puncture attempts between the two groups (P = 0.041). CEUS gro...

show abstract

mentioning

confidence: 99%

Contrast-enhanced US-guided percutaneous biopsy of anterior mediastinal lesions

Mao²,

Ping³

et al. 2017

Diagn Interv Radiol

View full text Add to dashboard Cite

show abstract

“…In cases of malignancy, the decrease begins in the portal-venous phase in most cases after slow marginal arterial enhancement. Tumor lesions of HCC, liver adenoma, high-f low hemangioma and focal nodular hyperplasia can show an early arterial enhancement in the first 30 s in perfusion curves [4,6,8,12,13] . These lesions may be masked in the portalvenous phase.…”

Section: Discussionmentioning

confidence: 99%

“…This may explain why the early phase of enhancement might not be effective for some very small HCC lesions. Early arterial enhancement can be found in 76%-96% of HCC lesions, and homogeneous enhancement in the late phase in 3%-30% of the patients [4,6,8,12,13] . The detection rate still remains examiner-dependent, even with low-MI contrast-agent techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Since no www.wjgnet.com single diagnostic tool has been able to clarify this question with sufficient reliability up to now, histological analysis remains the gold standard. Characterization of focal hepatic lesions with imaging techniques is an important part of radiological diagnosis and is still the focus of scientific research because of technical innovations of existing methods [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] . Special attention has been paid to the validation of new methods, especially the further development of contrast-enhanced ultrasound techniques because ultrasound is the most common and best available imaging technique [1][2][3][5][6][7][8][9][10][11][12][13][14] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of quantitative contrast harmonic imaging to assess malignancy of liver tumors: A prospective controlled two-center study

Jung

Clevert²,

Schreyer³

et al. 2007

WJG

View full text Add to dashboard Cite

AIM:To e s t a b l i s h t h e e x t e n t t o w h i c h c o n t ra s t enhancement with SonoVue in combination with quantitative evaluation of contrast-medium dynamics facilitates the detection of hepatic tumors. METHODS:One hundred patients with histologically confirmed malignant or benign hepatic tumor (maximum size 5 cm) were analyzed. Contrast-enhanced ultrasound (bolus injection 2.5 mL SonoVue) was carried out with intermittent breath-holding technique using a multifrequency transducer (2.5-4 MHz). Native vascularization was analyzed with power Doppler. The contrast-enhanced dynamic ultrasound investigation was carried out with contrast harmonic imaging in true detection mode during the arterial, portal venous and late phases. Mechanical index was set at 0.15. Perfusion analysis was performed by post-processing of the raw data [time intensity curve (TIC) analysis]. The cutoff of the gray value differences between tumor and normal liver tissue was established using Receiver Operating Characteristic (ROC) analysis 64-line multislice computed tomography served as reference method in all cases. Magnetic resonance tomography was used additionally in 19 cases. RESULTS:One hundred patients with 59 malignant (43 colon, 5 breast, 2 endocrine metastases, 7 hepatocellular carcinomas and 2 kidney cancers) and 41 benign (15 hemangiomas, 7 focal nodular hyperplasias, 5 complicated cysts, 2 abscesses and 12 circumscribed fatty changes) tumors were included. The late venous phase proved to be the most sensitive for classification of the tumor type. Fifty-eight of the 59 malignant tumors were classified as true positive, and one as false negative. This resulted in a sensitivity of 98.3%. Of the 41 benign tumors, 37 were classified as true negative and 4 as false negative, which corresponds to a specificity of 90.2%. Altogether, 95.0% of the diagnoses were classified as correct on the basis of the histological classification. No investigator-dependency (P = 0.23) was noted. CONCLUSION:The results show the possibility of accurate prediction of malignancy of hepatic tumors with a positive prognostic value of 93.5% using advanced contrast-enhanced ultrasound. Contrast enhancement with SonoVue in combination with quantitative evaluation of contrast-medium dynamics is a valuable tool to discriminate hepatic tumors.

show abstract

“…In some cases, a continuous infusion may be the better choice while in other cases the procedure may be performed without a second contrast injection if the perfusion conditions are adequately demonstrated with the first CEUS to allow for a standard ultrasound guided procedure. CEUS-guided biopsy has been reported to increase the diagnostic accuracy rate by up to 10 % either by directing the biopsy towards contrast-enhanced -and thus viable -tissue inside the tumour and thereby avoiding sampling of necrotic material, or by identifying previously not-visualised lesions more accessible for biopsy [4,[68][69][70][71][72]. Furthermore, CEUS may visualise active bleeding, hemobilia or segmental liver infarction.…”

Section: Ceus-guided Interventionsmentioning

confidence: 99%

Untitled

2018

Ultrasound Int Open

View full text Add to dashboard Cite

The Role of Contrast-Enhanced Sonography of Focal Liver Lesions Before Percutaneous Biopsy

Cited by 92 publications

References 24 publications

Contrast-enhanced US-guided percutaneous biopsy of anterior mediastinal lesions

Contrast-enhanced US-guided percutaneous biopsy of anterior mediastinal lesions

Evaluation of quantitative contrast harmonic imaging to assess malignancy of liver tumors: A prospective controlled two-center study

Untitled

Contact Info

Product

Resources

About