Usefulness of Combination of Imaging Modalities in the Diagnosis of Hepatocellular Carcinoma Using Sonazoid®-Enhanced Ultrasound, Gadolinium Diethylene-Triamine-Pentaacetic Acid-Enhanced Magnetic Resonance Imaging, and Contrast-Enhanced Computed Tomography

Alaboudy, Alshimaa; Inoue, Takamitsu; Hatanaka, Kinuyo; Chung, Hobyung; Hyodo, Toru; Kumano, Seishi; Murakami, Takamichi; Abdo, Ehab Fawzy; Kudo, Masatoshi

doi:10.1159/000333264

Cited by 36 publications

(25 citation statements)

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“…It has actually become common to encounter cases where hypervascular HCC or nodule-in-nodule HCC that is undetectable by MDCT is detected in a routine screening by EOB-MRI because of early enhancement in the arterial phase or clear hypointensity in the hepatobiliary phase [11,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103]. Furthermore, studies comparing the diagnostic performance of EOB-MRI and MDCT for hypervascular HCC have shown that EOB-MRI is superior or, at the very l...…”

Section: Diagnostic Algorithmmentioning

confidence: 99%

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

et al. 2014

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Surveillance and diagnostic algorithms for hepatocellular carcinoma (HCC) have already been described in guidelines published by the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver and the European Organisation for Research and Treatment of Cancer (EASL-EORTC), and the Japan Society of Hepatology (JSH), but the content of these algorithms differs slightly. The JSH algorithm mainly differs from the other two algorithms in that it is highly sophisticated and considers the functional imaging techniques of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI (EOB-MRI) and Sonazoid contrast-enhanced ultrasound (CEUS) to be very important diagnostic modalities. In contrast, the AASLD and EASL-EORTC algorithms are less advanced and suggest that a diagnosis be made based solely on hemodynamic findings using dynamic CT/MRI and biopsy findings. A consensus meeting regarding the JSH surveillance and diagnostic algorithm was held at the 50th Liver Cancer Study Group of Japan Congress, and a 2014 update of the algorithm was completed. The new algorithm reaffirms the very important role of EOB-MRI and Sonazoid CEUS in the surveillance and diagnosis of liver cancer and is more sophisticated than those currently used in the United States and Europe. This is now an optimized algorithm that can be used to diagnose early-stage to classical HCC easily and highly accurately.

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Section: Diagnostic Algorithmmentioning

confidence: 99%

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

et al. 2014

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“…CEUS is able to depict tumor vascularity sensitively and accurately [12,13,14,15,16]. In particular, when using only perfluorocarbon microbubbles (sonazoid), HCCs have been shown as defects during the Kupffer phase [10,17,18,19,20,21]. These defect lesions could be used as targets for the insertion of a RFA needle [22,23,24,25,26,27,28].…”

Section: Introductionmentioning

confidence: 99%

Combination Guidance of Contrast-Enhanced US and Fusion Imaging in Radiofrequency Ablation for Hepatocellular Carcinoma with Poor Conspicuity on Contrast-Enhanced US/Fusion Imaging

Minami

Minami²,

Chishina³

et al. 2014

Oncology

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Purpose: The purpose of this study was to evaluate the usefulness of the combination guidance of contrast-enhanced US (CEUS) and fusion imaging in radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) with poor conspicuity on B-mode US and CEUS/fusion imaging. Materials and Methods: We conducted a retrospective cohort study, which included 356 patients with 556 HCCs that were inconspicuous on B-mode US. A total of 192 patients with 344 HCCs, 123 patients with 155 HCCs, and 37 patients with 57 HCCs underwent RFA under CEUS guidance, fusion imaging guidance, and the combination of CEUS and fusion imaging guidance. Results: The average number of treatment sessions was 1.1 (range: 1-2) in the CEUS guidance group, 1.1 (range: 1-2) in the fusion imaging guidance group, and 1.1 (range: 1-3) in the combination of CEUS and fusion imaging guidance group. Treatment analysis did not reveal significantly more RFA treatment sessions in the combination guidance group than in the other groups (p = 0.97, Student's t test). During the follow-up period (1.1-85.3 months, mean ± SD, 43.2 ± 59.5), the 3-year local tumor progression rates were 4.9, 7.2, and 5.9% in the CEUS guidance group, the fusion imaging guidance group, and the combination guidance group, respectively (p = 0.84, log-rank test). Conclusion: In spite of selection bias, session frequency and local tumor progression were not different under the combination guidance with CEUS and fusion imaging in RFA. The combination of fusion imaging and CEUS guidance in RFA therapy is an effective treatment for HCC with poor conspicuity on B-mode US and CEUS/fusion imaging.

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“…Therefore, diagnosing the disease in the stage of hypovascular early hepatocellular carcinoma is considered to contribute to a better prognosis. For hyperarterialized moderately or more differentiated hepatocellular carcinoma, various imaging modalities show similar diagnostic performance, but it tends to be higher in Gd-EOB-MRI than in dynamic MDCT [65]. The degree of malignancy of nodules evaluated by CT with intra-arterial contrast injection and signal intensity in the hepatocyte phase of Gd-EOB-MRI are correlated with the degree of malignancy of borderline lesions, and the early liver cancer type was more markedly hypointense and detected more frequently than the DN type.…”

Section: Commentsmentioning

confidence: 99%

The essence of the Japan Radiological Society/Japanese College of Radiology Imaging Guideline

et al. 2015

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Diagnostic imaging is undoubtedly important in modern medicine, and final clinical decisions are often made based on it. Fortunately, Japan has the highest numbers of diagnostic imaging instruments, such as CT and MRI devices, and boasts easy access to them as well as a high level of diagnostic accuracy. In consequence, a very large number of imaging examinations are performed, but diagnostic instruments are installed in so many medical facilities that expert management of these examinations tends to be insufficient. Particularly, in order to avoid risks, clinicians have recently become indifferent to indications of imaging modalities and tend to rely on CT or MRI resulting in increasing the number of imaging examinations in Japan. This is a serious problem from the viewpoints of avoidance of unnecessary exposure and medical economy. Under these circumstances, the Japan Radiological Society and Japanese College of Radiology jointly initiated the preparation of new guidelines for diagnostic imaging. However, the field of diagnostic imaging is extremely wide, and it is impossible to cover all diseases. Therefore, in drafting the guidelines, we selected important diseases and focused on ''showing evidence and suggestions in the form of clinical questions (CQs)'' concerning clinically encountered questions and ''describing routine imagingThe Japan Radiological Society/Japanese College of Radiology Imaging Guideline was published in 2013.The homepage of the Japan Radiological Society contains information about all CQs of the Japanese Imaging Guideline 2013 as an English version http://www.radiology.jp/english/guideline.html. Radiol (2016) 34:43-79 DOI 10.1007 techniques presently considered to be standards to guarantee the quality of imaging examinations''. In so doing, we adhered to the basic principles of assuming the readers to be ''radiologists specializing in diagnostic imaging'', ''simultaneously respecting the global standards and attending to the situation in Japan'', and ''making the guidelines consistent with those of other scientific societies related to imaging''. As a result, the guidelines became the largest ever, consisting of 152 CQs, nine areas of imaging techniques, and seven reviews, but no other guidelines in the world summarize problems concerning diagnostic imaging in the form of CQs. In this sense, the guidelines are considered to reflect the abilities of diagnostic radiologists in Japan. The contents of the guidelines are essential knowledge for radiologists, but we believe that they are also of use to general clinicians and clinical radiological technicians. While the number and contents of CQs are still insufficient, and while chapters such as those on imaging in children and emergency imaging need to be supplemented, the guidelines will be serially improved through future revisions. Lastly, we would like to extend our sincere thanks to the 153 members of the drafting committee who authored the guidelines, 12 committee chairpersons who coordinated their efforts, six members of the...

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Usefulness of Combination of Imaging Modalities in the Diagnosis of Hepatocellular Carcinoma Using Sonazoid®-Enhanced Ultrasound, Gadolinium Diethylene-Triamine-Pentaacetic Acid-Enhanced Magnetic Resonance Imaging, and Contrast-Enhanced Computed Tomography

Cited by 36 publications

References 38 publications

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

Surveillance and Diagnostic Algorithm for Hepatocellular Carcinoma Proposed by the Liver Cancer Study Group of Japan: 2014 Update

Combination Guidance of Contrast-Enhanced US and Fusion Imaging in Radiofrequency Ablation for Hepatocellular Carcinoma with Poor Conspicuity on Contrast-Enhanced US/Fusion Imaging

The essence of the Japan Radiological Society/Japanese College of Radiology Imaging Guideline

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