Literature DB >> 23396623

Can contrast-enhanced ultrasonography characterize focal liver lesions and differentiate between benign and malignant, thus providing a one-stop imaging service for patients?().

D D Cokkinos1, M J Blomley, C J Harvey, A Lim, C Cunningham, D O Cosgrove.   

Abstract

PURPOSE: Contrast-enhanced ultrasonography (CEUS) displays high sensitivity and specificity in characterizing focal liver lesions (FLLs). We attempted to determine how often CEUS provides an unequivocal diagnosis of FLLs that does not require additional imaging studies.
MATERIALS AND METHODS: Seventy-three patients with 146 FLLs were scanned with B-mode, Doppler, and contrast-enhanced US (2 × 2.4 ml SonoVue, low MI, 4-6 MHz curved array transducer, Toshiba Aplio/Siemens-Acuson Sequoia). Data were digitally stored and transferred to a work station with the GE PACS system. Images were reviewed by a consultant radiologist experienced in CEUS and interpreted in accordance with the criteria for characterizing FLLs published by the European Federation of Societies for Ultrasound in Medicine and Biology. Diagnoses were compared with those based on computed tomography (CT) and/or magnetic resonance (MR) findings if these were available. However, our aim was to assess the frequency with which CEUS provided diagnoses that were considered reliable enough to exclude the need for other imaging studies. Therefore, the CEUS diagnoses were not necessarily confirmed by other methods.
RESULTS: Based on CEUS findings alone, 130/146 (89.0%) FLLs could be classified as benign or malignant, and in 118/146 (80.8%) cases, the lesion could be specifically identified. The other 28/146 (19.2%) FLLs could not be characterized based on CEUS data alone. In 58 (80.8%) of the 73 patients with multiple FLLs, CEUS findings were sufficient to establish the benign vs. malignant nature of all the patient's lesions; in 51/73 (69.9%) patients, all the lesions could also be characterized with CEUS. In the remaining cases, at least one lesion required additional imaging to determine whether it was malignant (14/73, 19.2%) or to establish its identity (22/73, 30.1%). In 4/73 (5.5%) patients, CEUS revealed additional lesions not detected on B-mode US.
CONCLUSIONS: CEUS alone was sufficient to classify 89.0% of the FLLs as benign or malignant, and in 80.8% it was also regarded as sufficient to identify the lesion. It served as a one-stop diagnostic test for 80.8% of the patients, reducing the need for CT-MR scans and providing savings in terms of radiation exposure, time, and money.

Entities:  

Keywords:  Contrast agents; Cost benefit; Focal liver lesions; Ultrasound

Year:  2007        PMID: 23396623      PMCID: PMC3552653          DOI: 10.1016/j.jus.2007.09.002

Source DB:  PubMed          Journal:  J Ultrasound        ISSN: 1876-7931


  13 in total

Review 1.  [Contrast ultrasound imaging in liver disease].

Authors:  F Tranquart; A Bleuzen; J M Correas; A Kissel; J Tchuenbou; E Vandooren
Journal:  J Radiol       Date:  2003-12

2.  Characterization of focal liver lesions with contrast-specific US modes and a sulfur hexafluoride-filled microbubble contrast agent: diagnostic performance and confidence.

Authors:  Emilio Quaia; Fabrizio Calliada; Michele Bertolotto; Sandro Rossi; Lorena Garioni; Laura Rosa; Roberto Pozzi-Mucelli
Journal:  Radiology       Date:  2004-08       Impact factor: 11.105

3.  Intra-operative uses of contrast-enhanced ultrasound.

Authors:  A K Siösteen; A Elvin
Journal:  Eur Radiol       Date:  2004-10       Impact factor: 5.315

Review 4.  Potential impact and utilization of ultrasound contrast media.

Authors:  Edward Leen; Susan J Moug; Paul Horgan
Journal:  Eur Radiol       Date:  2004-10       Impact factor: 5.315

5.  Phase-inversion sonography during the liver-specific late phase of contrast enhancement: improved detection of liver metastases.

Authors:  T Albrecht; C W Hoffmann; S A Schmitz; S Schettler; A Overberg; C T Germer; K J Wolf
Journal:  AJR Am J Roentgenol       Date:  2001-05       Impact factor: 3.959

6.  Importance of evaluating all vascular phases on contrast-enhanced sonography in the differentiation of benign from malignant focal liver lesions.

Authors:  Carlos Nicolau; Ramon Vilana; Violeta Catalá; Luis Bianchi; Rosa Gilabert; Angeles García; Concepcio Brú
Journal:  AJR Am J Roentgenol       Date:  2006-01       Impact factor: 3.959

7.  Improved detection of hepatic metastases with pulse-inversion US during the liver-specific phase of SHU 508A: multicenter study.

Authors:  Thomas Albrecht; Martin J K Blomley; Peter N Burns; Stephanie Wilson; Christopher J Harvey; Edward Leen; Michel Claudon; Fabrizio Calliada; Jean-Michel Correas; Michel LaFortune; Rodolfo Campani; Christian W Hoffmann; David O Cosgrove; Frederic LeFevre
Journal:  Radiology       Date:  2003-03-20       Impact factor: 11.105

8.  Characterization of focal liver lesions: comparative study of contrast-enhanced ultrasound versus spiral computed tomography.

Authors:  V Catala; C Nicolau; R Vilana; M Pages; L Bianchi; M Sanchez; C Bru
Journal:  Eur Radiol       Date:  2006-10-27       Impact factor: 5.315

9.  Differential diagnosis of hepatic tumors by using contrast enhancement patterns at US.

Authors:  Tetsuo Isozaki; Kazushi Numata; Takayoshi Kiba; Koji Hara; Manabu Morimoto; Takashi Sakaguchi; Hisahiko Sekihara; Toru Kubota; Hiroshi Shimada; Toshio Morizane; Katsuaki Tanaka
Journal:  Radiology       Date:  2003-10-16       Impact factor: 11.105

10.  Characterization of hepatic tumors: value of contrast-enhanced coded phase-inversion harmonic angio.

Authors:  Yan Ling Wen; Masatoshi Kudo; Rong Qin Zheng; Hong Ding; Pei Zhou; Yasunori Minami; Hobyung Chung; Masayuki Kitano; Toshihiko Kawasaki; Kiyoshi Maekawa
Journal:  AJR Am J Roentgenol       Date:  2004-04       Impact factor: 3.959

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  2 in total

1.  High frame-rate contrast enhanced ultrasound (HIFR-CEUS) in the characterization of small hepatic lesions in cirrhotic patients.

Authors:  F Giangregorio; M Garolfi; E Mosconi; L Ricevuti; M G Debellis; M Mendozza; C Esposito; E Vigotti; D Cadei; D Abruzzese
Journal:  J Ultrasound       Date:  2022-10-13

Review 2.  Hepatosplenic sarcoidosis: contrast-enhanced ultrasound findings and implications for clinical practice.

Authors:  Claudio Tana; Christoph F Dietrich; Cosima Schiavone
Journal:  Biomed Res Int       Date:  2014-08-18       Impact factor: 3.411

  2 in total

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