Preliminary Clinical Experience with Shear Wave Dispersion Imaging for Liver Viscosity in Preoperative Diagnosis of Focal Liver Lesions

2020 ◽  
Vol 58 (09) ◽  
pp. 847-854
Author(s):  
Yi Dong ◽  
Yijie Qiu ◽  
Qi Zhang ◽  
Daohui Yang ◽  
Lingyun Yu ◽  
...  
Keyword(s):  
Shear Wave ◽  
Liver Tumors ◽  
Area Under The Curve ◽  
Wave Dispersion ◽  
Liver Parenchyma ◽  
Final Diagnosis ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Medical Systems ◽  
The Right

Abstract Background The aim of our study is to analyze viscosity characteristics of focal liver lesions (FLLs) and the diagnostic performance of shear wave dispersion (SWD) in differentiating benign and malignant FLLs. Methods Between January 2018 and April 2018, 58 consecutive patients (median age 57, age range 21–74 years, 37 males) with 58 FLLs located on the right lobe of liver were prospectively studied. The Aplio i900 series diagnostic ultrasound system (Canon Medical systems) equipped with a curvilinear PV1-475BX transducer (1–8 MHz) was used. SWD slope and viscosity measurements were expressed as mean ± standard deviation for both liver tumors and background liver parenchyma. Histopathological results after surgery were regarded as the gold standard for diagnosis. Results Final diagnosis included 40 cases of malignant and 18 cases of benign FLLs. The mean viscosity value were 14.78 ± 1.86 m/s/kHz for hepatocellular carcinoma (n = 30), 14.81 ± 2.35 m/s/kHz for liver metastasis lesions (n = 10), 13.23 ± 1.31 m/s/kHz for hemangioma (n = 13), and 13.67 ± 2.72 m/s/kHz for focal nodular hyperplasia (n = 5). Malignant FLLs showed higher mean viscosity values (14.79 ± 3.15 m/s/KHz) than benign FLLs (13.36 ± 2.76 m/s/KHz) (p < 0.05). The best performing cut-off value of lesion viscosity was 13.15 m/s/kHz (sensitivity 83.3 %; specificity 56.5 %; area under the curve (AUC) 0.71) for malignancy) (p < 0.05). Conclusions The analysis of SWD slope and liver viscosity parameters provide additional viscoelastic information about FLLs before operation.

Shear Wave Dispersion Imaging for the Characterization of Focal Liver Lesions – A Pilot study

2021 ◽  
Author(s):  
Daniel Jesper ◽  
Steffen Fiedler ◽  
Daniel Klett ◽  
Maximilian J Waldner ◽  
Barbara Schellhaas ◽  
...  
Keyword(s):  
Shear Wave ◽  
Wave Dispersion ◽  
Liver Parenchyma ◽  
Benign Tumors ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Shear Wave Speed ◽  
Lower Shear ◽  
Malignant Lesions

Abstract Purpose Shear wave dispersion imaging is a novel ultrasound-based technique, which analyzes the speed of different shear wave components depending on their frequency. The dispersion of shear wave speed correlates with the viscosity of the liver parenchyma. The aim of this prospective study was to evaluate the use of shear wave dispersion imaging in focal liver lesions in the non-cirrhotic liver. Methods Patients with unclear focal liver lesions in B-mode ultrasound were prospectively assigned to shear wave dispersion imaging (m/s/kHz). Measurements were conducted within the lesion and in the liver parenchyma of the right liver lobe using an intercostal window. Histology and contrast-enhanced ultrasound served as the reference for the characterization of the lesions. Results Out of 46 patients included in this study, 24 had liver metastases and 22 had benign liver lesions. Benign lesions consisted mostly of hemangiomas (n=12) and focal nodular hyperplasia (n=8). Malignant lesions showed significantly lower shear wave dispersion (13.0±2.45 m/s/kHz) compared to benign tumors (15.2±2.74 m/s/kHz, p<0.01). In further subgroup analysis, the difference was significant for hemangiomas (15.32±2.42 m/s/kHz, p=0.04) but not for FNHs (14.98±3.36 m/s/kHz, p=0.38). The dispersion of reference liver parenchyma did not differ significantly between the groups (p=0.54). Conclusion The quantification of viscosity by shear wave dispersion is a new parameter for the characterization of focal liver lesions with higher dispersion values in hemangiomas and lower dispersion values in metastases. However, it cannot differentiate reliably between benign and malignant lesions.

scholarly journals Evaluation of Solid Focal Liver Lesions by Shear Wave Sonoelastography with FNAC Correlation

2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Singla Ashu ◽  
TT Vishwanath ◽  
Das Sudha Kiran ◽  
Murthy Nagaraj ◽  
Patil Vikram ◽  
...  
Keyword(s):  
Shear Wave ◽  
Focal Liver Lesions ◽  
Liver Lesions

scholarly journals Hepatocellular Carcinoma Is the Most Frequent Final Diagnosis of Focal Liver Lesions Identified in a Cross-Sectional Evaluation of Patients with Chronic Liver Disease in Saudi Arabia

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Adnan Agha ◽  
Manuele Furnari ◽  
Rafaat Morched Chakik ◽  
Mamdouh M. Abdulhadi Ali ◽  
Dib Alsaudi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Disease ◽  
Chronic Liver Disease ◽  
Odds Ratio ◽  
Final Diagnosis ◽  
Liver Lesion ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Benign Lesions ◽  
Cross Sectional

Background. Hepatocellular carcinoma (HCC) is a frequent diagnosis in patients with chronic liver disease (CLD) and a newly identified liver lesion, although benign diseases may also be responsible for this finding. Objective. To evaluate the characteristics of focal liver lesions in a population of patients with CLD not under surveillance for HCC in the Middle East. Methods. We performed a cross-sectional study evaluating 77 patients with CLD and a focal liver lesion identified during ultrasonography. Patients’ characteristics were analyzed on the basis of the final diagnosis (HCC versus benign lesions). Results. The most frequent diagnosis was HCC (64.9%). These patients were older (median age 64 versus 55 years, P=0.003) and cirrhotics (80.0% versus 51.9%, P=0.018), with multinodular lesions (58.0% versus 29.6%, P=0.031) and portal vein thrombosis (24.0% versus 0%, P=0.001) compared to patients with benign lesions. Prevalence of elevated alpha-fetoprotein (>10 ng/mL) was similar in both groups (80.0% versus 88.9%, P=0.198). Cirrhosis (odds ratio: 3.283) and multinodularity (odds ratio: 2.898) were independently associated with HCC. Conclusions. HCC is the most common diagnosis in Middle-Eastern patients with CLD and a liver lesion identified outside HCC surveillance programs, especially in cirrhotic patients. In these patients, elevated alpha-fetoprotein does not differentiate HCC from benign lesions.

scholarly journals Is There a Place for Elastography in the Diagnosis of Hepatocellular Carcinoma?

2021 ◽  
Vol 10 (8) ◽  
pp. 1710
Author(s):  
Ana-Maria Ghiuchici ◽  
Ioan Sporea ◽  
Mirela Dănilă ◽  
Roxana Șirli ◽  
Tudor Moga ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Shear Wave Elastography ◽  
Abdominal Ultrasound ◽  
Liver Parenchyma ◽  
Final Diagnosis ◽  
Focal Liver Lesions ◽  
Additional Information ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced

Background and Aims: Elastography can provide information regarding tissue stiffness (TS). This study aimed to analyze the elastographic features of hepatocellular carcinoma (HCC) and the factors that influence intratumoral elastographic variability in patients with liver cirrhosis. Methods: This prospective study included 115 patients with liver cirrhosis and hepatocellular carcinoma evaluated between June 2016–November 2019. A total of 88 HCC nodules visualized in conventional abdominal ultrasound (US) met the inclusion criteria and underwent elastographic evaluation. Elastographic measurements (EM) were performed in HCC and liver parenchyma using VTQ (Virtual Touch Quantification), a point shear wave elastography (pSWE) technique. In all patients, we performed contrast-enhanced ultrasound (CEUS), and the final diagnosis of HCC was established by contrast-enhanced-CT or contrast-enhanced-MRI. Results: The mean VTQ values in HCCs were 2.16 ± 0.75 m/s. TS was significantly lower in HCCs than in the surrounding liver parenchyma 2.16 ± 0.75 m/s vs. 2.78 ± 0.92 (p < 0.001). We did not find significant differences between the first five and the last five EM, and the intra-observer reproducibility was excellent ICC: 0.902 (95% CI: 0.87–0.950). However, the tumor size, heterogeneity, and depth correlated with higher intralesional stiffness variability (p < 0.001). Conclusions: VTQ brings additional information for HCC characterization. Intra-observer reproducibility for both HCC and liver parenchyma was excellent. Knowing the stiffness of HCC’s might endorse an algorithm-based approach towards focal liver lesions (FLLs) in liver cirrhosis.

scholarly journals Value of Contrast-Enhanced Ultrasound in Differential Diagnosis of Focal Liver Lesions

2017 ◽  
pp. 36-52
Author(s):  
E. I. Peniaeva ◽  
J. R. Kamalov ◽  
A. N. Sencha ◽  
U. N. Patrunov ◽  
E. A. Sencha
Keyword(s):  
Differential Diagnosis ◽  
Contrast Enhancement ◽  
Complex Analysis ◽  
Final Diagnosis ◽  
Arterial Phase ◽  
Focal Liver Lesions ◽  
Diagnostic Feature ◽  
Liver Lesions ◽  
Contrast Enhanced ◽  
Venous Phase

Purpose:to evaluate the diagnostic value of contrastenhanced ultrasound (CEUS) with SonoVue in differential diagnosis of focal liver lesions (FLL) in a multidisciplinary clinic in Russian Federation.Materials and methods. Bolus intravenous administration of 1.2 ml of SonoVue (Bracco Swiss CA, Switzerland) followed with 5ml saline flush was used for liver CEUS. We utilized the scanners Mindray DC-8 (Mindrаy, China), Logiq S8 (GE, USA), Philips Epiq 7 (Philips, Holland), SonoScape S9 (SonoScape, China), Hitachi Ascendus (Hitachi, Japan) with 3.0–5.0 MHz convex probes in specialized “contrast” mode with low mechanic index (MI 0.08–0.1). The study conferred 73 patients in the age between 18 and 84 years (mean age 49 years) with FLL. CEUS was performed in 22 patients with previously verified diagnosis, while the rest of patients underwent CEUS before the final diagnosis. Contrast-enhanced liver CT was performed in all patients. In 49 (67.12%) of 73 cases, a pathology was performed after a targeted core-needle biopsy or autopsy. Qualitative features of US contrast enhancement of FLL were evaluated.Results. Qualitative aspects of CEUS for differentiation of FLL were defined. The principal sign for diagnosis between benign and malignant masses with CEUS was hypoenhancement of malignant lesions in comparison to surrounding normal parenchyma in portal and late venous phase (p ≤ 0.01). Alternatively, hyper- or isoenhancement throughout late venous phase was characteristic for benign FLL. Diffuse heterogeneous contrast enhancement was indicative of malignant FLL, and homogeneous – for benign. Additional diagnostic feature (p ≤ 0.05) was the type of contrast enhancement in the arterial phase. Heterogeneous diffuse contrast enhancement was observed in malignant FLL, while homogeneous – in benign FLL. Peripheral nodular contrast enhancement with centripetal filling was characteristic for liver hemangioma, centrifugal filling with “spoke-wheel” vascular pattern – for FNH, and peripheral rim-like hyperenhancement with rapid achievement of hypoenhancement at the beginning of the portal phase – for liver metastasis.Conclusion.Complex analysis of qualitative characteristics of CEUS with SonoVue is a promising option for differential diagnosis of FLL (sensitivity 92.85%, specificity 91.3%, diagnostic accuracy 92.15%) and can be utilized in daily practice.

scholarly journals CT Texture Analysis of Abdominal Lesions – Part I.: Liver lesions

Imaging ◽  
2021 ◽  
Author(s):  
Bettina Katalin Budai ◽  
Veronica Frank ◽  
Sonaz Shariati ◽  
Bence Fejér ◽  
Ambrus Tóth ◽  
...  
Keyword(s):  
Texture Analysis ◽  
Liver Tumors ◽  
Machine Learning Techniques ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Non Invasive ◽  
Learning Techniques ◽  
Ct Texture Analysis ◽  
Malignant Liver ◽  
Abdominal Lesions

ABSTRACTArtificial Intelligence and the use of radiomics analysis have been of great interest in the last decade in the field of imaging. CT texture analysis (CTTA) is a new and emerging field in radiomics, which seems promising in the assessment and diagnosis of both focal and diffuse liver lesions. The utilization of CTTA has only been receiving great attention recently, especially for response evaluation and prognostication of different oncological diagnoses. Radiomics, combined with machine learning techniques, offers a promising opportunity to accurately detect or differentiate between focal liver lesions based on their unique texture parameters. In this review article, we discuss the unique ability of radiomics in the diagnostics and prognostication of both focal and diffuse liver lesions. We also provide a brief review of radiogenomics and summarize its potential role of in the non-invasive diagnosis of malignant liver tumors.

scholarly journals Role of vasculoendothelial growth factor and its gene in pathogenesis of hepatobiliary pathology

2020 ◽  
Vol 37 (4) ◽  
pp. 36-45
Author(s):  
A. P. Schekotova ◽  
I. A. Bulatova
Keyword(s):  
Growth Factor ◽  
Liver Tumors ◽  
Liver Lesion ◽  
Load Level ◽  
Focal Liver Lesions ◽  
Liver Pathology ◽  
Liver Lesions ◽  
Vegf Gene ◽  
Its Gene

Objective. To assess the pathogenetic value of vasculoendothelial growth factor (VEGF) and polymorphism of its gene in hepatobiliary pathology. Materials and methods. The study included 190 patients with hepatobiliary pathology (HBP): 100 patients with chronic hepatitis C (CHC) in the reactivation phase, 50 with HC in the outcome of CHC, 30 with cholelithiasis, 10 with focal liver lesions (including 8 with primary and secondary liver tumors). Results. In case of hepatobiliary pathology, VEGF, as indicator neoangiogenesis and endothelial dysfunction (ED), is a marker of the severity of liver lesion: its production is increased in some patients with cholelithiasis, moderately elevated in all patients with CH and significantly elevated against the background of HC and liver pathology of the tumor genesis. In chronic diffuse diseases of the liver, there are detected multiple reliable relationships between VEGF and a number of ED indices, hepatic clinical and biochemical syndromes, liver fibrosis markers, viral load level that proves the obligate involvement of VEGF in the development and progression of liver pathology. VEGF can be used as a test for differential diagnosis of fibrosis in CH and HC with the sensibility of 90 % and specificity of 78 %. Carriage of the allele C in the locus of the VEGF gene (G-634C) in the form of homozygote CC can show the risk of more severe lesion of the liver in CHC and is interconnected with increased production of VEGF. Conclusions. Vasculoendothelial growth factor and polymorphism of its gene is involved in the pathogenesis of hepatobiliary pathology, activating neoangiogenesis and fibrosis in the liver.

scholarly journals Aim: To investigate the value of ElastPQ measurement for differential diagnosis of benign and malignant focal liver lesions (FLLs) by using histologic results as a reference standard. Material and methods: A total of 154 patients were included. ElastPQ measurement was performed for each lesion in which the shear wave speed (SWS) was measured. The difference in SWS and SWS ratio of FLL to surrounding liver were evaluated, and the cut off value was investigated. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic performance. Histology as a gold standard was obtained by surgery in all patients. Results: A total of 154 lesions including 129 (83.7 %) malignant FLLs and 25 (16.3 %) benign ones were analysed. The SWS of malignant and benign FLLs was significantly different, 2.77±0.68 m/s and 1.57±0.55 m/s (p<0.05). The SWS ratio of each FLL to surrounding liver parenchyma was 2.23±0.49 for malignant and 1.14±0.36 for benign FLLs (p<0.05). The cut off value for differential diagnosis was 2.06 m/s for SWS and 1.67 for SWS ratio. Conclusions: ElastPQ measurement provides reliable quantitative stiffness information of FLLs and may be helpful in the differential diagnosis between malignant and benign FLLs.

2017 ◽  
Vol 19 (3) ◽  
pp. 259 ◽  
Author(s):  
Yi Dong ◽  
Wen-Ping Wang ◽  
Yadan Xu ◽  
Jiaying Cao ◽  
Feng Mao ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Gold Standard ◽  
Diagnostic Performance ◽  
Wave Speed ◽  
Operating Characteristic ◽  
Liver Parenchyma ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Shear Wave Speed ◽  
The Difference

Aim: To investigate the value of ElastPQ measurement for differential diagnosis of benign and malignant focal liver lesions (FLLs) by using histologic results as a reference standard.Material and methods: A total of 154 patients were included. ElastPQ measurement was performed for each lesion in which the shear wave speed (SWS) was measured. The difference in SWS and SWS ratio of FLL to surrounding liver were evaluated, and the cut off value was investigated. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic performance. Histology as a gold standard was obtained by surgery in all patients.Results: A total of 154 lesions including 129 (83.7 %) malignant FLLs and 25 (16.3 %) benign ones were analysed. The SWS of malignant and benign FLLs was significantly different, 2.77±0.68 m/s and 1.57±0.55 m/s (p<0.05). The SWS ratio of each FLL to surrounding liver parenchyma was 2.23±0.49 for malignant and 1.14±0.36 for benign FLLs (p<0.05). The cut off value for differential diagnosis was 2.06 m/s for SWS and 1.67 for SWS ratio.Conclusions: ElastPQ measurement provides reliable quantitative stiffness information of FLLs and may be helpful in the differential diagnosis between malignant and benign FLLs.

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