scholarly journals Contrast-enhanced ultrasound for the assessment of focal nodular hyperplasia – results of a multicentre study

2021 ◽  
Author(s):  
Roxana Şirli ◽  
Ioan Sporea ◽  
Alina Popescu ◽  
Mirela Dănilă ◽  
Daniela Larisa Săndulescu ◽  
...  
Keyword(s):  
Focal Nodular Hyperplasia ◽  
Predictive Value ◽  
De Novo ◽  
Arterial Phase ◽  
Mechanical Index ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Nodular Hyperplasia

Aim: Contrast-enhanced ultrasound (CEUS) has become a relevant imaging method for the evaluation of focal liver le-sions (FLL). The aim of this study was to evaluate the performance of CEUS for the assessment of focal nodular hyperplasia (FNH) in a large study group. Material and methods: We performed a multicentre prospective observational study, which included successive CEUS examinations from fourteen Romanian centres. CEUS examinations were performed in de novo FLL, using low mechanical index ultrasound, following an intravenous bolus of 2.4 ml SonoVue. CEUS was considered conclusive for FNH if a typical pattern was present following contrast (rapid “spoke-wheel” enhancement during the arterial phase, hyperenhanced lesion during venous phase, hyper- or isoenhanced in the late phase). In all cases a reference method was available (contrast enhanced CT or MRI or biopsy). The trial was registered in clinicaltrials.gov (Identifier NCT01329458). Results: During the 6 years study, 2062 “de novo” FLL were evaluated by CEUS. From this cohort, 94/2062 (4.5%) had a typical enhancing pattern for FNH as described in the EFSUMB guidelines. Contrast enhanced CT/MRI and biopsy diagnosed additional 15 FNH. From the 94 cases diagnosed as FNH by CEUS, in nine the final diagnosis was different (five of them adenomas). CEUS had 85% sensitivity, 99.5% specificity, 90.4% positive predictive value, 99.2% negative predictive value and 98.8% diagnostic accuracy for the diagnosis of FNH. Conclusions: CEUS is a sensitive and very specific method for the diagnosis of FNH.

scholarly journals Application of Contrast-Enhanced Ultrasound (CEUS) in Lymphomatous Lymph Nodes: A Comparison between PET/CT and Contrast-Enhanced CT

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Xuelei Ma ◽  
Wenwu Ling ◽  
Fan Xia ◽  
Yifan Zhang ◽  
Chenjing Zhu ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
False Negative ◽  
False Negative Rate ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Therapeutic Decisions ◽  
Pet Ct ◽  
Enhanced Ct

Purpose. We described imaging characteristics of different types of lymphomas using contrast-enhanced ultrasound (CEUS) and summarized some simple criteria to distinguish between normal lymph nodes and lymphomatous lymph nodes for clinical diagnosis. Materials and methods. Sixty-one lymphoma patients from 2014 to 2015 with 140 suspicious lymph nodes, who had been confirmed by histology and underwent chemotherapy, were enrolled in our study. The responses to chemotherapy were recorded by PET/CT, contrast-enhanced CT, or CEUS. Results. We summarized the CEUS enhancement patterns as two types when detecting lymphomatous lymph nodes, which could be the specific diagnostic criteria: (1) rapid well-distributed hyperenhancement, with 83.1% lesions exhibiting a fast-in hyperenhancement pattern in the arterial phase, and (2) rapid heterogeneous hyperenhancement, with 16.9% lesions exhibiting heterogeneous in the arterial phase. Particularly, we found that all the suspicious lesions of indolent lymphomas were rapid well-distributed hyperenhancement. CEUS successfully identified 117 lymphomatous lymph nodes, while PET/CT and contrast-enhanced CT detected 124 and 113 lymphomatous lymph nodes, respectively. CEUS had an accuracy of 83.57%, and the accuracy of PET/CT and contrast-enhanced CT was 88.57% and 80.71%, respectively (p=0.188). The false-negative rate was 16.43%, 11.43%, and 19.29%, respectively (p=0.188). Conclusion. CEUS could be a useful tool in detecting lymphomatous nodes. A rapid well-distributed hyperenhancement pattern in CEUS could be a useful diagnostic criterion in both aggressive lymphoma and indolent lymphoma. These results can help us distinguish between lymphomatous and benign lymph nodes and make better diagnostic and therapeutic decisions.

scholarly journals Delayed response to proton beam treatment of hepatocellular carcinoma

2020 ◽  
Vol 6 (1) ◽  
pp. 20180125
Author(s):  
Chee-Wai Cheng ◽  
Mitchell Machtay ◽  
Jennifer Dorth ◽  
Olga Sergeeva ◽  
Hangsheng Xia ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Ct Scan ◽  
Proton Beam ◽  
Arterial Phase ◽  
Delayed Response ◽  
Data Set ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Imaging Response

Hepatocellular carcinoma (HCC) has become one of the leading causes of cancer death worldwide. There has been anecdotal report regarding the effectiveness of proton beam treatment for HCC. In this pre-clinical investigation, the woodchuck model of viral hepatitis infection-induced HCC was used for proton beam treatment experiment. The radiopaque fiducial markers that are biodegradable were injected around the tumor under ultrasound guidance to facilitate positioning in sequential treatments. An α cradle mode was used to ensure reproducibility of animal positioning on the treatment couch. A CT scan was performed first for contouring by a radiation oncologist. The CT data set with contours was then exported for dose planning. Three fractionations, each 750 CcGyE, were applied every other day with a Mevion S250 passive scattering proton therapy system. Multiphase contrast-enhanced CT scans were performed after the treatment and at later times for follow-ups. 3 weeks post-treatment, shrinking of the HCC nodule was detected and constituted to a partial response (30% reduction along the long axis). By week nine after treatment, the nodule disappeared during the arterial phase of multiphase contrast-enhanced CT scan. Pathological evaluation corroborated with this imaging response. A delayed, but complete imaging response to proton beam treatment applied to HCC was achieved with this unique and clinically relevant animal model of HCC.

Diagnostic Features of Real-Time Contrast-Enhanced Ultrasound in Focal Nodular Hyperplasia of the Liver

2009 ◽  
Vol 31 (03) ◽  
pp. 276-282 ◽  
Author(s):  
F. Piscaglia ◽  
A. Venturi ◽  
M. Mancini ◽  
F. Giangregorio ◽  
G. Vidili ◽  
...  
Keyword(s):  
Real Time ◽  
Focal Nodular Hyperplasia ◽  
Contrast Enhanced Ultrasound ◽  
Diagnostic Features ◽  
Contrast Enhanced ◽  
Nodular Hyperplasia
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