Clinical and Contrast-enhanced Ultrasound Characteristics of Epithelioid and Classic Hepatic Angiomyolipoma: Comparison With Alpha-fetoprotein–negative Hepatocellular Carcinoma

Zou, Min-Hong; Huang, Qing; Zou, Qiong; Jiang, Ye; Ju, Jinxiu; Zhou, Honghang; Jiao, Ju; Zheng, Rongqin

doi:10.1016/j.ultrasmedbio.2020.11.021

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…It is a bit tricky to tell the difference between these two since the clinical and laboratory clues are lost. Previous studies have found that Sonovue CEUS was useful for differentiating HAML from HCC [1,14,15], but no studies have explored the diagnostic potential of Sonazoid CEUS in this respect. So far, only two case reports have demonstrated the characteristics of HAML on Sonazoid CEUS [16,17].…”

Section: Discussionmentioning

confidence: 99%

Contrast-enhanced ultrasound features of hepatic angiomyolipoma: comparison with AFP-negative and non-viral hepatocellular carcinoma

Zhang,

Guo,

Liao

et al. 2024

Ultrasound Int Open

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Purpose This study aimed to compare contrast-enhanced ultrasound (CEUS) features of hepatic angiomyolipoma (HAML) and challenging cases of HCC, mainly those with no hepatitis infection but also with a low level of AFP (non-viral AFP- HCC). Materials and Methods The study included pathologically confirmed HAMLs and non-viral AFP- HCCs undergoing CEUS from 2012 to 2023. Sonovue (SV) CEUS and Sonazoid (SZ) CEUS characteristics of the two groups were compared. Results The study included 50 HAMLs (24% on SZ-CEUS) and 88 non-viral AFP- HCCs (21.6% on SZ-CEUS). The CEUS characteristics on SZ-CEUS were similar to those on SV-CEUS to a certain extent. HAMLs more frequently displayed no washout and partial washout with partial no washout, so-called PWNW, in the late phase and post-vascular phase, whereas HCCs more commonly exhibited mild washout. In the post-vascular phase, all non-viral AFP- HCCs exhibited washout, thereby facilitating differentiation from no-washoutHAMLs, superior to SV-CEUS, where some non-viral AFP- HCCs still exhibited no washout in late phase that could not be distinguished from HAMLs. It is noteworthy that PWNW was exclusively found in nodules exhibiting hyper- and hypoechoic separation of the nodules, and hyper- and hypoechoic separation of HAMLs in the post-vascular phase on SZ-CEUS demonstrated PWNW more frequently compared to the late phase, which can potentially help distinguish nodules with hyper- and hypoechoic separation as either HAML or non-viral AFP- HCC. Conclusion: This study highlighted the usefulness of SV- and SZ-CEUS for distinguishing HAML and non-viral AFP- HCC and filled in existing gaps regarding the SZ-CEUS features of HAML.

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Section: Discussionmentioning

confidence: 99%

Contrast-enhanced ultrasound features of hepatic angiomyolipoma: comparison with AFP-negative and non-viral hepatocellular carcinoma

Zhang,

Guo,

Liao

et al. 2024

Ultrasound Int Open

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“…In comparison, the arterial-phase rim enhancement has high diagnostic sensitivity for AFP-negative HCC, up to 95.1%, but low specificity, only 63.2%, that is, about 40% of primary other types of malignancies of the liver are misclassified as HCC, mainly because other hypervascular lesions of the liver often show this feature, such as hepatic angiomyolipoma [ 20 ]. Zou et al [ 21 ] have found that epithelioid angiomyolipoma (EAML) is more easily misdiagnosed as AFP-negative HCC because hepatic EAML shows enhancement patterns that are similar to those of AFP -negative HCC. Therefore, the diagnostic efficacy of non-rim enhancement in the arterial phase for HCC needs to be further explored in the future.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of CEUS LI-RADS Version 2017 in Differentiating AFP-Negative Hepatocellular Carcinoma from Other Primary Malignancies of the Liver

et al. 2021

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Purpose: To explore the diagnostic value of Contrast-enhanced Ultrasound Liver Imaging Reporting and Data System version 2017 (CEUS LI-RADS v2017) in differentiating alpha-fetoprotein (AFP)-negative hepatocellular carcinoma (HCC) from other primary malignancies (OM) of the liver. Methods: The data of 99 patients with primary liver malignant tumors confirmed by surgical pathology and AFP-negative from January 2018 to January 2021 were retrospectively analyzed, and the lesions were divided into 61 cases in the AFP-negative HCC group and 38 cases in the OM group according to the pathological findings, the CEUS features of the lesions were analyzed and the lesions were classified according to the CEUS LI-RADS v2017. Comparison of CEUS features between the two groups was performed using the χ2 test. The sensitivity, specificity, positive predictive value, negative predictive value, and coincidence rate of CEUS LI-RADS v2017 for the diagnosis of AFP-negative HCC and OM were calculated using pathological findings as the gold standard. Results: The differences in features of arterial phase enhancement and wash-out between the HCC and OM groups were statistically significant (p < 0.05). The sensitivity of diagnosing HCC by LR-5 was 62.3% and the specificity was 92.1%. The sensitivity of diagnosing OM by LR-M was 92.1% and the specificity was 83.6%. Conclusions: When AFP is negative in patients with intrahepatic focal lesions, LR-5 has high specificity but low sensitivity in the diagnosis of HCC, and LR-M has high sensitivity and specificity in the diagnosis of OM. CEUS LI-RADS is a tool to differentiate AFP-negative HCC and OM effectively.

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Baseline and contrast-enhanced ultrasound features of hepatic epithelioid angiomyolipoma

Fan

Cao

et al. 2022

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BACKGROUND: Recurrence or metastasis after surgery had been reported in hepatic epithelioid angiomylipoma (epi-AML). Most hepatic epi-AMLs were misdiagnosed with hepatocellular carcinoma or other hepatic tumors before surgery. OBJECTIVE: To describe the baseline and contrast-enhanced ultrasound (CEUS) features of hepatic epi-AMLs and to explore the potential ultrasonic features for prognosis. METHODS: The retrospective study enrolled 67 patients (56 females, 11 males) with 67 pathologically confirmed hepatic epi-AML lesions. All the lesions were examined by baseline ultrasound and 42 lesions were examined using CEUS with SonoVue (Bracco, Milan, Italy) before surgery. RESULTS: Baseline ultrasound features of hepatic epi-AMLs included heterogeneous echo (86.6%), well-defined border (68.7%), hypoecho (64.2%), regular morphology (62.7%), peripheral-tumor arc-shaped or ring-like vessels (53.7%), and low value of resistive index (0.51±0.08). CEUS features of hepatic epi-AMLs included arterial phase hyper-enhancement with smooth and well-defined margin (100%), peripheral-tumor ring-like vessels (57.1%), and intra-tumor vessels (52.4%). Some CEUS features, including arterial phase heterogeneously tortuous filling, intra-tumor vessels and peripheral-tumor ring-like vessels were more commonly found in hepatic epi-AMLs of uncertain malignant potential/malignant than in benign hepatic epi-AMLs (p < 0.05). CONCLUSIONS: Baseline ultrasound and CEUS features may be useful in diagnosis of hepatic epi-AML, and some CEUS features may be indicative of its malignant potential.

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Clinical and Contrast-enhanced Ultrasound Characteristics of Epithelioid and Classic Hepatic Angiomyolipoma: Comparison With Alpha-fetoprotein–negative Hepatocellular Carcinoma

Cited by 3 publications

References 28 publications

Contrast-enhanced ultrasound features of hepatic angiomyolipoma: comparison with AFP-negative and non-viral hepatocellular carcinoma

Contrast-enhanced ultrasound features of hepatic angiomyolipoma: comparison with AFP-negative and non-viral hepatocellular carcinoma

Diagnostic Value of CEUS LI-RADS Version 2017 in Differentiating AFP-Negative Hepatocellular Carcinoma from Other Primary Malignancies of the Liver

Baseline and contrast-enhanced ultrasound features of hepatic epithelioid angiomyolipoma

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