Correlation between SonoVue Enhancement in CEUS, HCC Differentiation and HCC Diameter: Analysis of 130 Patients with Hepatocellular Carcinoma (HCC)

Herbay, A. von; Vogt, Christoph; Westendorff, Julia; Häussinger, Dieter; Gregor, Mariana Chavez-Mac

doi:10.1055/s-0028-1109745

Cited by 26 publications

(21 citation statements)

References 16 publications

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“…Small ICCs, particularly those measuring <2 cm in diameter and those in cirrhotic livers, usually present homogeneous hyperenhancement on CEUS, which may be easily misdiagnosed as HCC [8,11]. However, it is well known that small HCCs are well differentiated pathologically and may present slow contrast washout on CEUS [26,31,32]. Therefore, we believe this feature is extremely useful for the differentiation of small HCCs from ICCs, particularly for tumors in the cirrhotic liver.…”

Section: Discussionmentioning

confidence: 95%

Contrast-Enhanced Ultrasound for the Characterization of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

Liu¹,

Wang²,

Lü³

et al. 2015

Liver Cancer

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Purpose and methods: The ability of contrast-enhanced ultrasound (CEUS) to differentiate between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) is still controversial. We reviewed the CEUS imaging of 819 patients (HCC=546, ICC=273) with an established pathological diagnosis. The enhancement patterns of lesions and the diagnostic performance of CEUS were analyzed. Results: Arterial hyperenhancement followed by washout was observed in 92.3% (504/546) of the HCC lesions and 85.7% (234/273) of the ICC lesions on CEUS (p<0.05). Additionally, the ICCs presented contrast washout much earlier than the HCCs, with an average time of 27.5 seconds after injecting the contrast agent compared with 70.1 seconds for the HCCs (p<0.05). Peripheral rim-like enhancement was observed in 68.5% (187/273) of the ICCs, which was significantly more common than that in the HCCs (2.0%, 11/546) (p<0.05). When using arterial hyperenhancement with a washout phase later than 43 seconds after injecting the contrast agent and with no peripheral rim-like enhancement as the diagnostic criteria for HCC ≤5 cm in diameter, the area under the curve was 0.808, with 64.1% sensitivity, 97.4% specificity and 73.6% accuracy. Conclusions: Although ICC may show the typical enhancement pattern of HCC on CEUS, peripheral rim-like enhancement and quick contrast washout show high efficiency in the differentiation of HCC from ICC.

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Section: Discussionmentioning

confidence: 95%

Contrast-Enhanced Ultrasound for the Characterization of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

Liu¹,

Wang²,

Lü³

et al. 2015

Liver Cancer

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“…Some authors consider that early pronounced contrast enhancement of a nodule within 1-2 cm developed on a cirrhotic liver is sufficient for HCC diagnosis (Jang et al, 2009). These results prove that for a correct characterization of the lesions it is necessary to extend the examination time to 5 minutes or even longer (von Herbay et al, 2009). …”

Section: Early Hepatocellular Carcinoma (Early Hcc)mentioning

confidence: 91%

“…There are studies showing that the wash out process is directly correlated with the size and features of neoplastic circulatory bed. Thus, highly differentiated HCC illustrates the phenomenon of late or even very late "wash out" while poorly differentiated HCC has an accelerated wash out at the end of arterial phase (Strobel et al, 2005;von Herbay et al, 2009;Jang et al, 2009).…”

Section: Early Hepatocellular Carcinoma (Early Hcc)mentioning

confidence: 99%

Ultrasound Imaging of Liver Tumors – Current Clinical Applications

Badea¹,

Ioaniţescu²

2012

Liver Tumors

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“…In accordance with the grade of malignancy of tumor nodules, intranodular portal blood supply gradually decreased, and almost completely disappeared in moderately or poorly differentiated HCC. On the other hand, intranodular arterial supply first decreased in dysplastic nodules and borderline lesions, and then dramatically increased in malignant lesions [19,25].…”

Section: Discussionmentioning

confidence: 99%

“…The early detection of small tumor lesions allows new chances for a successful tumor surgery [23,25]. An essential contribution could be therefore the enhanced detection of microvascularization of the tumor using high resolution contrast techniques.…”

Section: Discussionmentioning

confidence: 99%

Characterization of microvascularization of liver tumor lesions with high resolution linear ultrasound and contrast enhanced ultrasound (CEUS) during surgery: First results

Jung

Ross

Rennert

et al. 2010

Clinical Hemorheology and Microcirculation

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Aim: Evaluation of high resolution linear ultrasound and intra-operative linear contrast enhanced ultrasound (CEUS) and its benefit for the detection and characterization of tumor lesions.Material and methods: Twenty patients were investigated preoperatively regarding tumor detection using CT (n = 8) or MRI (n = 12) and image fusion (VNav) (n = 3). All patients had surgery for their hepatic tumor (hepatocellular carcinoma (HCC), cholangiocellular carcinoma (CCC), metastasis, and adenoma).Ultrasound was performed intra-operatively first with B-scan using a convex probe. Than multifrequency linear transmitters (6-9 MHz, 6-15 MHz, LOGIQ E9, GE) were applied for B-scan, coulor coded Doppler sonography (CCDS) and Power Doppler followed by dynamic CEUS with Contrast Harmonic Imaging (CHI) after bolus injection of a maximum of 15 mL SonoVue ® .Results: In 9 cases with the use of intra-operative CEUS additional tumor lesions (diameter 4-15 mm) could be detected and were histologically confirmed after surgical resection (7 cases) or intra-operative biopsy (2 cases). Using intraoperative CEUS 64 tumor lesions could be detected compared to 51 tumor lesions detected by preoperative CT or MRI (p < 0.05). Using the 6-15 MHz multifrequency linear transducer with CHI, arterial perfusion of adenomas, neuroendocrine metastases and HCC lesions was detectable. In 3 cases a resection was not achievable. Two of these cases were treated with radio frequency ablation (RFA). The other case had no curable option due to multifocal tumor manifestation.Conclusion: The intra-operative use of high-resolution linear transducer techniques with CEUS offers new diagnostic perspectives for an effective liver surgery.

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Correlation between SonoVue Enhancement in CEUS, HCC Differentiation and HCC Diameter: Analysis of 130 Patients with Hepatocellular Carcinoma (HCC)

Abstract: In well-differentiated HCCs (G1) hyperechoic enhancement in the arterial phase and hypoechoic demarcation in the late phase correlate to the diameter.

Cited by 26 publications

References 16 publications

Contrast-Enhanced Ultrasound for the Characterization of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

Contrast-Enhanced Ultrasound for the Characterization of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

Ultrasound Imaging of Liver Tumors – Current Clinical Applications

Characterization of microvascularization of liver tumor lesions with high resolution linear ultrasound and contrast enhanced ultrasound (CEUS) during surgery: First results

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