scholarly journals Diagnostic value of Virtual Touch Quantification (VTQ®) for differentiation of hemangiomas from malignant focal liver lesions

2019 ◽  
Vol 21 (4) ◽  
pp. 371 ◽  
Author(s):  
Giovanni Galati ◽  
Antonio De Vincentis ◽  
Paolo Gallo ◽  
Alessandro Guidi ◽  
Umberto Vespasiani-Gentilucci ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Shear Wave Velocity ◽  
Abdominal Ultrasound ◽  
Diagnostic Value ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Lower Shear ◽  
Hepatocellular Carcinomas ◽  
Significant Difference ◽  
Malignant Lesions

Aim: To evaluate the diagnostic value of Virtual Touch Quantification (VTQ®) for characterizing benign vs. malignant focal liver lesions (FLLs).Material and methods: From January 2015 to January 2016 all consecutive FLLs visualized during a conventional abdominal ultrasound (US), underwent VTQ® evaluation, taking five measurements of both the lesion and the surrounding parenchyma.Results: We studied 119 FLLs, consisting of 52 hemangiomas (HEs), 39 hepatocellular carcinomas (HCCs), and 28 liver metastases (METs). HEs showed a significantly lower shear wave velocity (SWV) values compared to malignant FLLs (HEs SWV median value 1.34 m/sec, IQR 0.9; malignant lesions SWV median value 2.69 m/sec, IQR 1.6; p<0.001). Moreover, a nodule-to-parenchyma SWV ratio showed a significant difference in HEs and METs (p<0.001) but not in HCCs (p=0.03). SWV values were able to correctly differentiate malignant lesions with c-statistics of 0.82 (95 % CI 0.74- 0.90) and sensitivity of 74.6%/specificity of 80.7% at a cut-off of 2 m/sec.Conclusions: Our results suggest that VTQ® is able to distinguish HEs from malignant lesions (HCCs and METs) at a SWV cut-off of 2 m/sec.

scholarly journals The Prevalence of Hyperechoic Rim in Solid Focal Liver Lesions and Its Implication

2018 ◽  
Vol 35 (1) ◽  
pp. 3-8
Author(s):  
Size Wu ◽  
Dongsheng Zuo ◽  
Yamin Hong
Keyword(s):  
Magnetic Resonance Imaging ◽  
Focal Liver Lesions ◽  
Clinical Implications ◽  
Liver Lesions ◽  
Resonance Imaging ◽  
Benign Lesions ◽  
Hepatocellular Carcinomas ◽  
Significant Difference ◽  
Malignant Lesions ◽  
Solid Lesions

The objective of this study was to investigate the prevalence and clinical implications of the hyperechoic rim of liver focal solid lesions. A retrospective review was conducted of sonograms of focal liver lesions with a hyperechoic rim, as well as relative examinations such as computed tomography, magnetic resonance imaging, biopsy, resection, and histopathology reports. A cohort of 10 232 patients was found to have solid focal liver lesions (2030 malignant, 8202 benign). A hyperechoic rim was determined in 182 hemangiomas, 2 granulomas, 2 hepatocellular carcinomas (HCCs), and 4 other malignancies. There were significant differences between malignant and benign lesions ( P < .001), between HCCs and hemangiomas ( P < .001), between malignancies and hemangiomas ( P < .001), between HCCs and granulomas ( P = .044), and between other malignancies and granulomas ( P = .005). There was no significant difference between liver granulomas and hemangiomas ( P = .656). In this study, a hyperechoic rim in solid focal liver lesions appeared mainly in hemangiomas, granulomas, and rarely in malignant lesions.

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 Diagnostic value of Diffusion Weighted Imaging in assessment of malignant focal liver lesions

2009 ◽  
Vol 56 (4) ◽  
pp. 121-125 ◽  
Author(s):  
R.M. Maksimovic ◽  
M.S. Kratovac-Dunjic ◽  
G.B. Lilic ◽  
R.M. Milenkovic ◽  
D.M. Masulovic ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Diagnostic Value ◽  
Focal Liver Lesions ◽  
Cavernous Haemangioma ◽  
Liver Lesions ◽  
Secondary Tumors ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Adc Values ◽  
Hepatic Lesions

Introduction: The study was designed to determine if there was a difference between apparent diffusion coefficient (ADC) values using diffusion weighted imaging (DWI) MRI technique between different malignant focal liver lesions. Patients and methods: The study included 63 patients with focal hepatic lesions: fourteen patients (22.2%) with hepatocellular carcinoma (HCC), 16 patients (25.4%) with hepatic metastatic colorectal tumors, 17 patients (26.9%) with cavernous haemangioma and 16 patients (25.4%) with hepatic cysts. MRI was performed with 1.5T scanner, using EPI sequence with ADC values being determined for all lesions based on three b values. Results: ADC values were statistically different among the groups (F=70.7, p<0.01): HCC patients 1.11+0.29x10- 3 s/mm2, metastatic tumours 2.18+0.15x10-3 s/mm2, haemangioma 2.22+0.32x10-3 s/mm2, cysts 3.08+0.03 x10-3 s/mm2. Furthermore, there was statistically significant difference between benign lesions (haemangioma and cysts, 2.36+0.43x10-3 s/mm2), and malignant diseases (HCC and secondary tumors, 1.52+0.58x10-3 s/mm2), t=5,6, p<0.01. Conclusion: DWI technique could be helpful in defining the focal liver lesions.

scholarly journals Quantitative Analysis of the Time–Intensity Curve of Contrast-Enhanced Ultrasound of the Liver: Differentiation of Benign and Malignant Liver Lesions

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1244
Author(s):  
Sonja Schwarz ◽  
Dirk-André Clevert ◽  
Michael Ingrisch ◽  
Thomas Geyer ◽  
Vincent Schwarze ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Diagnostic Accuracy ◽  
Late Phase ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Malignant Lesions ◽  
Benign Liver ◽  
Benign Liver Lesions

Background: To evaluate the diagnostic accuracy of quantitative perfusion parameters in contrast-enhanced ultrasound to differentiate malignant from benign liver lesions. Methods: In this retrospective study 134 patients with a total of 139 focal liver lesions were included who underwent contrast enhanced ultrasound (CEUS) between 2008 and 2018. All examinations were performed by a single radiologist with more than 15 years of experience using a second-generation blood pool contrast agent. The standard of reference was histopathology (n = 60), MRI or CT (n = 75) or long-term CEUS follow up (n = 4). For post processing regions of interests were drawn both inside of target lesions and the liver background. Time–intensity curves were fitted to the CEUS DICOM dataset and the rise time (RT) of contrast enhancement until peak enhancement, and a late-phase ratio (LPR) of signal intensities within the lesion and the background tissue, were calculated and compared between malignant and benign liver lesion using Student’s t-test. Quantitative parameters were evaluated with respect to their diagnostic accuracy using receiver operator characteristic curves. Both features were then combined in a logistic regression model and the cumulated accuracy was assessed. Results: RT of benign lesions (14.8 ± 13.8 s, p = 0.005), and in a subgroup analysis, particular hemangiomas (23.4 ± 16.2 s, p < 0.001) differed significantly to malignant lesions (9.3 ± 3.8 s). The LPR was significantly different between benign (1.59 ± 1.59, p < 0.001) and malignant lesions (0.38 ± 0.23). Logistic regression analysis with RT and LPR combined showed a high diagnostic accuracy of quantitative CEUS parameters with areas under the curve of 0.923 (benign vs. malignant) and 0.929 (hemangioma vs. malignant. Conclusions: Quantified CEUS parameters are helpful to differentiate malignant from benign liver lesions, in particular in case of atypical hemangiomas.

scholarly journals The role of quantitative diffusion-weighted imaging in characterization of hypovascular liver lesions: A prospective comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247301
Author(s):  
Jelena Djokić Kovač ◽  
Marko Daković ◽  
Aleksandra Janković ◽  
Milica Mitrović ◽  
Vladimir Dugalić ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Liver Metastases ◽  
Diffusion Weighted Imaging ◽  
Intraclass Correlation ◽  
Intravoxel Incoherent Motion ◽  
Liver Lesions ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Apparent Diffusion

Background The utility of intravoxel incoherent motion (IVIM) related parameters in differentiation of hypovascular liver lesions is still unknown. Purpose The purpose of this study was to evaluate the value of IVIM related parameters in comparison to apparent diffusion coefficient (ADC) for differentiation among intrahepatic mass-forming cholangiocarcinoma (IMC), and hypovascular liver metastases (HLM). Methods Seventy-four prospectively enrolled patients (21 IMC, and 53 HLM) underwent 1.5T magnetic resonance examination with IVIM diffusion-weighted imaging using seven b values (0–800 s/mm2). Two independent readers performed quantitative analysis of IVIM-related parameters and ADC. Interobserver reliability was tested using a intraclass correlation coefficient. ADC, true diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and perfusion fraction (ƒ) were compared among the lesions using Kruskal-Wallis H test. The diagnostic accuracy of each parameter was assessed by receiver operating characteristic (ROC) curve analysis. Results The interobserver agreement was good for ADC (0.802), and excellent for D, D*, and ƒ (0.911, 0.927, and 0.942, respectively). ADC, and D values were significantly different among IMC and HLM (both p < 0.05), while there was no significant difference among these lesions for ƒ and D* (p = 0.101, and p = 0.612, respectively). ROC analysis showed higher diagnostic performance of D in comparison to ADC (AUC = 0.879 vs 0.821). Conclusion IVIM-derived parameters in particular D, in addition to ADC, could help in differentiation between most common hypovascular malignant liver lesions, intrahepatic mass—forming cholangiocarcinoma and hypovascular liver metastases.

Accuracy of US-Guided FNA of Focal Liver Lesions in Dogs: 140 Cases (2005–2008)

2013 ◽  
Vol 49 (3) ◽  
pp. 190-196 ◽  
Author(s):  
Katherine L. Bahr ◽  
Leslie C. Sharkey ◽  
Tsuyoshi Murakami ◽  
Daniel A. Feeney
Keyword(s):  
Abdominal Ultrasound ◽  
Focal Liver Lesions ◽  
Lower Sensitivity ◽  
Relative Distribution ◽  
Liver Lesions ◽  
Vacuolar Change ◽  
Degree Of Confidence ◽  
Low Sensitivity ◽  
High Degree ◽  
Pathologic Processes

Medical records from dogs having abdominal ultrasound (US) performed between March 2005 and October 2008 were reviewed for detection of focal liver lesions (FLL) with both cytologic and histologic sampling. Samples were classified as to either the presence or absence of major categories of pathologic processes, including malignant neoplasia, inflammation, hyperplasia/benign neoplasia, vacuolar change, extramedullary hematopoeisis, cholestasis, necrosis, and no microscopic abnormalities. Evaluation of selection bias was performed by review of the relative distribution of cytologic diagnoses for cases with histology compared with cases excluded from the comparison analysis because histology results were not available. Cytology had the highest sensitivity for vacuolar change (57.9%), followed by neoplasia (52.0%). Cytology had the highest positive predictive value (PPV) for neoplasia (86.7%) followed by vacuolar change (51.6%). Cytology had lower sensitivity and PPVs for inflammation, necrosis, and hyperplasia. The ability of cytology to characterize disease in canine FLL varies by pathologic process. Clinicians can have a high degree of confidence when a cytologic diagnosis of neoplasia is given; however, cytology is less reliable for excluding the potential for neoplasia. Cytology has a low sensitivity and PPV for inflammation and a limited diagnostic performance for the diagnosis of vacuolar change.

Efficiency of Abdominal Ultrasound and Computer Tomography in Diagnostic and Differential Diagnostic of Focal Liver Lesions

2015 ◽  
Vol 15 (1) ◽  
pp. 18-22
Author(s):  
Janis Vilmanis ◽  
Arturs Ozolins ◽  
Janis Gardovskis
Keyword(s):  
Liver Biopsy ◽  
Ct Scan ◽  
Computer Tomography ◽  
Abdominal Ultrasound ◽  
Focal Liver Lesions ◽  
Imaging Method ◽  
Liver Lesions ◽  
Good Imaging ◽  
Imaging Results ◽  
Hepatic Lesions

SummaryIntroduction. The liver is a parenchimal abdominal organ with wide variety of primary benign or malignant tumors as well as metastatic tumors.Aim of the study. Was to evaluate the informativity and usefulness of abdominal ultrasound (US) and computer tomography (CT) imaging results in diagnostics of focal liver lesions.Material and methods. The study was conducted in Pauls Stradins Clinical University Hospital. Retrospective analysis of 126 patients with focal liver lesions was performed in the time period of 5 years (2009 till 2014). The medical records of patients with focal liver lesions were analyzed. Primary diagnosis detected by US or CT was evaluated and compared with final morphology after surgical operation or liver biopsy. The obtained results were expressed in percent and analyzed. Sensitivity and specificity of CT scan to detect malignant hepatic lesions was estimated and expressed as percentage with 95% confidence interval.Results. A total of 126 patients with diagnosed liver lesions were included in the study. 96 patients were in the group with performed liver CT scans, with median age of 58.9 years. 30 patients were included in the group with liver US, with median age of 60.1 years. Liver biopsy under US control was performed for 95 patients, but surgical operations with liver resections for 31 patients. 86 patients had malignant liver lesions, but 40 had benign liver lesions. In the US group primary and final diagnosis agreement was in 26 (87%) cases, but diagnosis disagreement in 4 (13%) cases. Diagnosis disagreement was found in 26 (27.1%) cases in the CT group, but agreement was in 70 (72.9%) cases. Overall sensitivity of CT to detect malignant hepatic lesions was 95.2% (95%CI 86.7-98.3%) and specificity was 64.7% (95%CI 47.9-78.5%).Conclusions. CT is a good imaging method for detection of focal liver lesions. In case of unclear diagnosis, percutaneous liver puncture biopsy is recommended. It is mandatory to develop a unified CT scan and US investigation protocol to improve the quality of investigation as well as further treatment tactics.

scholarly journals The Use of Contrast-Enhanced Ultrasonography for the Characterization of Focal Liver Lesions

2017 ◽  
Vol 33 (6) ◽  
pp. 500-511
Author(s):  
Jennifer E. Bagley ◽  
Dennis E. Paul ◽  
Sutton Halferty ◽  
Dora DiGiacinto
Keyword(s):  
High Sensitivity ◽  
Diagnostic Process ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Benign Lesions ◽  
Underlying Liver Disease ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Malignant Lesions

Focal liver lesions often occur with or without an underlying liver disease. Contrast-enhanced ultrasonography can aid in characterizing liver lesions, potentially avoiding biopsy and computed tomography procedures. Contrast-enhanced ultrasonography has a high sensitivity and specificity for differentiating characteristics of liver lesions compared with noncontrast sonography. The different contrast characteristics aid in differentiating benign and malignant lesions. Malignant lesions tend to have washout of contrast in the venous phases, whereas benign lesions have hyperenhancement during the venous phases. Therefore, contrast-enhanced ultrasonography should be considered an essential component of the diagnostic process for diagnosing and following focal liver lesions.

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