Focal liver lesions: sinusoidal phase of CEUS

D’Onofrio, Mirko; Martone, Enrico; Faccioli, Niccolò; Zamboni, Giulia; Malagò, Roberto; Mucelli, Roberto Pozzi

doi:10.1007/s00261-005-0066-5

Cited by 51 publications

(40 citation statements)

References 26 publications

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“…Of particular interest, though, is the fact that Sonazoid-enhanced US can show liver parenchymal images in the postvascular phase because Sonazoid microbubbles are phagocytosed by hepatic Kupffer cells, similar to Levovist, but which is not possible with SonoVue and Definity [11, 12, 19]. Previous reports have described that Levovist-enhanced US can detect liver tumors with a sensitivity of 87–91% [21,22,23]. However, Levovist-enhanced US has the limitation that the liver parenchymal image is obtained by only one scan.…”

Section: Discussionmentioning

confidence: 99%

Sonazoid-Enhanced Ultrasonography for Diagnosis of Hepatic Malignancies: Comparison with Contrast-Enhanced CT

Hatanaka

Kudo²,

Minami³

et al. 2008

Oncology

112

117

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Objective: The purpose of this study was to assess the usefulness of Sonazoid-enhanced ultrasonography (US) in the diagnosis of hepatic malignancies in comparison with contrast-enhanced CT findings. Methods: A total of 74 patients with 113 hepatic tumors having or highly suspected of having malignancies were enrolled. These hepatic nodules were diagnosed by typical findings of imaging such as contrast-enhanced CT, dynamic MRI or Sonazoid-enhanced US, tumor markers and histological examinations after surgical resection or biopsy. Results: 108 nodules were diagnosed as malignant tumors (hepatocellular carcinoma: n = 90; metastasis: n = 16; intrahepatic cholangiocarcinoma: n = 2) and the remaining five tumors were diagnosed as benign tumors (dysplastic nodules: n = 5). Sonazoid-enhanced US correctly depicted the presence or absence of tumors in 74 patients, with a sensitivity of 95.4%, an accuracy of 94.7%, and a positive predictive rate of 99%. Contrast-enhanced CT depicted the malignancies with a sensitivity of 85.2%, an accuracy of 82.3%, and a positive predictive rate of 95.8%. There were significant differences between Sonazoid-enhanced US and contrast-enhanced CT for sensitivity and accuracy (both p < 0.05). Conclusion: Sonazoid-enhanced US has a higher sensitivity and accuracy for the diagnosis of hepatic malignancies than contrast-enhanced CT.

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Section: Discussionmentioning

confidence: 99%

Sonazoid-Enhanced Ultrasonography for Diagnosis of Hepatic Malignancies: Comparison with Contrast-Enhanced CT

Hatanaka

Kudo²,

Minami³

et al. 2008

Oncology

112

117

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“…D'Onofrio et al [188] reported that SonoVue-enhanced US detected hepatic malignancy as defects in the sinusoidal phase, with a sensitivity of 85%, specificity of 88%, positive predictive value of 92%, and negative predictive value of 77%. In our study, Sonazoid-enhanced harmonic US detected hepatic malignancy with a sensitivity of 95% (208/219), specificity of 93.3% (28/30), positive predictive value of 99% (208/210), and negative predictive value of 97.4% (38/39).…”

Section: Combination Of Tumor Markersmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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“…Various gases or shells have been studied for their use as sonographic contrast agents [8][9][10][11] , and contrast-enhanced harmonic US using various media has been possible [6,[12][13][14] . Sonazoid has been licensed from January 2007 exclusively in Japan.…”

Section: Discussionmentioning

confidence: 99%

Differential Diagnosis of Hepatic Tumors: Value of Contrast-Enhanced Harmonic Sonography Using the Newly Developed Contrast Agent, Sonazoid

Hatanaka¹,

Kudo²,

Minami³

et al. 2008

Intervirology

143

151

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Objective: To clarify the value of contrast-enhanced harmonic ultrasonography (US) with Sonazoid, a second-generation US contrast agent, in the differential diagnosis of liver tumors compared to dynamic CT. Methods: A total of 249 hepatic nodules in 214 patients were studied; these included 177 hepatocellular carcinomas (HCCs), 42 liver metastases, 20 liver hemangiomas, 6 dysplastic nodules and 4 focal nodular hyperplasias (FNHs). After the injection of Sonazoid, nodules were scanned using real-time contrast-enhanced harmonic US in the vascular phases, i.e. the early and late vascular phases, and the Kupffer phase. Results: Six enhancement patterns were identified to be significant for the differential diagnosis of hepatic tumors. In HCCs, the presence of intratumoral vessels supplied from the periphery and fast washout (sensitivity, 96.6%; specificity, 94.4%) were the most typical characteristics. In metastases, the presence of rim-like enhancement with peripheral tumor vessels (sensitivity, 88.1%; specificity, 100%) was the typical pattern. In hemangiomas, the presence of intratumoral hypoperfusion images with globular or cotton wool-like pooling, which continue to the late vascular phase (sensitivity, 90.0%; specificity, 99.6%), was typical. In dysplastic nodules, the presence of portal enhancement without arterial supply in the early vascular phase and the presence of intratumoral uptake in the Kupffer phase (sensitivity, 83.3%; specificity, 100%) were the most typical patterns. In FNHs, the presence of a spoke-wheel pattern in the early vascular phase with dense staining in the late vascular phase, and positive uptake within the nodule in the Kupffer phase (sensitivity, 100%; specificity, 100%) were the most typical patterns. Conclusion: Contrast-enhanced harmonic US with Sonazoid allowed intimate vascular and Kupffer imaging and, therefore, is useful for the differential diagnosis of hepatic tumors.

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Focal liver lesions: sinusoidal phase of CEUS

Cited by 51 publications

References 26 publications

Sonazoid-Enhanced Ultrasonography for Diagnosis of Hepatic Malignancies: Comparison with Contrast-Enhanced CT

Sonazoid-Enhanced Ultrasonography for Diagnosis of Hepatic Malignancies: Comparison with Contrast-Enhanced CT

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Differential Diagnosis of Hepatic Tumors: Value of Contrast-Enhanced Harmonic Sonography Using the Newly Developed Contrast Agent, Sonazoid

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