Perfluorobutane contrast-enhanced ultrasonography for the diagnosis of HCC: a systematic review and meta-analysis

2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma

“…142 Moreover, regarding CEUS with Kupffer cell-specific contrast agents, a recent meta-analysis found a good overall diagnostic performance, with a sensitivity of 90% (95% CI, 82-95%) and a specificity of 97% (95% CI, 93-98%). 158 A prospective intra-individual comparative study reported that CEUS with Kupffer cell-specific contrast agents had a significantly higher sensitivity compared to CEUS with blood-pool contrast agents (79% [95% CI, 64-90%] vs. 54% [95% CI, 38-67%]), without difference in specificity (100% [95% CI, 79-100%] vs. 100% [95% CI, 79-100%]). 159 In another prospective study, CEUS with Kupffer cell-specific contrast agents demonstrated diagnostic performances similar to multiphasic CT Figure 5.…”

2022 Korean Liver Cancer Association-National Cancer Center Korea Practice Guidelines for Imaging Diagnosis of Hepatocellular Carcinoma: What’s New?

“…CEUS with a Kupffer cell-specific contrast agent has been adopted in the 2017 version of the Asian Pacific Association for the Study of the Liver guidelines, although CEUS with a blood-pool contrast agent has not been adopted [ 4 ]. The decision to add CEUS with a Kupffer cell-specific contrast agent to the diagnostic imaging modalities of KLCA-NCC v2022 is based on recent studies demonstrating that its diagnostic performance is good and comparable with that of CEUS with a blood-pool contrast agent and multiphasic CT and MRI [ 5 6 7 ]. However, as in the KLCA-NCC v2018 guidelines, CEUS is only recommended as a second-line imaging study because of its limitations in determining tumor extent and staging.…”

2022 KLCA-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma

“…As discussed above, CEUS with blood-pool contrast agent showed comparable diagnostic performance to multiphasic CT or MRI [ 142 ]. Moreover, regarding CEUS with Kupffer cell-specific contrast agents, a recent meta-analysis found a good overall diagnostic performance, with a sensitivity of 90% (95% CI, 82%–95%) and a specificity of 97% (95% CI, 93%–98%) [ 158 ]. A prospective intra-individual comparative study reported that CEUS with Kupffer cell-specific contrast agents had a significantly higher sensitivity compared to CEUS with blood-pool contrast agents (79% [95% CI, 64%–90%] vs. 54% [95% CI, 38%–67%]), without difference in specificity (100% [95% CI, 79%–100%] vs. 100% [95% CI, 79%–100%]) [ 159 ].…”