Contrast-enhanced ultrasonography features of hepatobiliary neoplasms in cats

BackgroundContrast-enhanced ultrasonography (CEUS) features of primary hepatobiliary neoplasms have been reported in dogs but no information is available in cats.MethodsQualitative and quantitative features of bile duct adenomas (BDAs, n=20), bile duct carcinomas (BDCs, n=16), and hepatocellular carcinomas (HCCs, n=8) are described in 44 cats.ResultsThere was an overlap in CEUS qualitative features between different histotypes, both in wash-in and wash-out phases. Distinction between different neoplasms based only on the CEUS qualitative features was not possible. At peak of enhancement, the BDAs, BDCs and HCCs showed a large range of echogenicities, from hypoenhancement to hyperenhancement, in comparison to the liver parenchyma. Eight of 20 BDAs showed inhomogeneous hyperenhancement during wash-in, which is a feature reported as typical of malignant lesions in dogs. BDC had a significantly faster wash-in compared with both BDA and HCC but the diagnostic accuracy of all the included quantitative variables was only moderate. No significant differences in the wash-out quantitative features of BDA and BDC were evident.ConclusionThere is poor evidence that CEUS may be used to distinguish between different primary hepatobiliary neoplasms in cats.

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

Diagnostics ◽

10.3390/diagnostics11071244 ◽

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.

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MO226A NEW DIAGNOSTIC TOOL FOR CKD PATIENTS: CONTRAST-ENHANCED ULTRASONOGRAPHY. A SINGLE CENTER EXPERIENCE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab092.00104 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Mirela Liana Gliga ◽

Cristian Chirila ◽

Paula Chirila ◽

Adriana Gomotarceanu ◽

Imola Torok ◽

...

Keyword(s):

Diagnostic Tool ◽

Final Diagnosis ◽

Medical System ◽

Focal Lesions ◽

Non Invasive ◽

Single Center Experience ◽

Contrast Enhanced ◽

Contrast Enhanced Ultrasonography ◽

Malignant Lesions ◽

Guidelines And Recommendations

Abstract Background and Aims Contrast-enhanced ultrasonography (CEUS) is a minimally invasive diagnostic tool available for diagnosing microvascular disturbances in tumors and many vascular pathologies. Unlike other radiological contrast agents, it is completely harmless for CKD patients and therefore it is used for the safe diagnosis of many diffuse or focal pathologies. Method We used CEUS examination in 50 CKD patients for the following pathologies: 10 atypical cysts, 15 liver focal lesions, 2 splenic focal lesions, 3 renal infarcts, 12 kidney focal lesions and 8 other organ involvements. Examination was made using a VOLUSON E8 machine (GE Medical System Kreztechnik GmbH Tiefenbach 15, Austria) with a 3.5 MHz convex array abdominal transducer. 2.4 ml of microbubble contrast-agent was administered intravenously and recording of the results were made for 3-5 minutes after injection. Results Depending on the organ vascular characteristics, contrast enhancement and/or wash-out were suggestive for the final diagnosis. In liver lesions there are three phases and in kidneys, spleen, gallbladder, adenopathies there are two vascular phases. We obtained a very good positive predictive value and sensitivity in detecting malignant lesions. Conclusion According to The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound they are used both for hepatic and Non-Hepatic Applications. Being non-invasive and non-irradiating it could be the main diagnostic examination in CKD population in the future.

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Pretreatment Evaluation with Contrast-Enhanced Ultrasonography for Percutaneous Radiofrequency Ablation of Hepatocellular Carcinomas with Poor Conspicuity on Conventional Ultrasonography

Korean Journal of Radiology ◽

10.3348/kjr.2013.14.5.754 ◽

2013 ◽

Vol 14 (5) ◽

pp. 754 ◽

Cited By ~ 13

Author(s):

Ah Yeong Kim ◽

Min Woo Lee ◽

Hyunchul Rhim ◽

Dong Ik Cha ◽

Dongil Choi ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Percutaneous Radiofrequency Ablation ◽

Hepatocellular Carcinomas ◽

Contrast Enhanced ◽

Contrast Enhanced Ultrasonography

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Diagnostic Accuracy of Hepatic Vein Arrival Time Performed with Contrast-Enhanced Ultrasonography for Cirrhosis: A Systematic Review and Meta-Analysis

Gut and Liver ◽

10.5009/gnl16031 ◽

2017 ◽

Vol 11 (1) ◽

pp. 93-101 ◽

Cited By ~ 12

Author(s):

Gaeun Kim ◽

Kwang Yong Shim ◽

Soon Koo Baik

Keyword(s):

Systematic Review ◽

Diagnostic Accuracy ◽

Hepatic Vein ◽

Arrival Time ◽

Meta Analysis ◽

Contrast Enhanced ◽

Contrast Enhanced Ultrasonography

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Evaluation of Hemodynamics in Focal Steatosis and Focal Spared Lesion of the Liver Using Contrast-Enhanced Ultrasonography with Sonazoid

Radiology Research and Practice ◽

10.1155/2014/604594 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Kazue Shiozawa ◽

Manabu Watanabe ◽

Takashi Ikehara ◽

Michio Kogame ◽

Mie Shinohara ◽

...

Keyword(s):

Fatty Liver ◽

Real Time ◽

Liver Parenchyma ◽

Target Lesion ◽

Invasive Procedures ◽

Enhancement Pattern ◽

The Third ◽

Fat Deposits ◽

Contrast Enhanced ◽

Contrast Enhanced Ultrasonography

We aim to investigate the hemodynamics in focal steatosis and focal spared lesion of the liver using contrast-enhanced ultrasonography (CEUS) with Sonazoid. The subjects were 47 patients with focal steatosis and focal spared lesion. We evaluated enhancement patterns (hyperenhancement, isoenhancement, and hypoenhancement) in the vascular phase and the presence or absence of a hypoechoic area in the postvascular phase for these lesions using CEUS. Of the 24 patients with focal steatosis, the enhancement pattern was isoenhancement in 19 and hypoenhancement in 5. Hypoechoic areas were noted in the postvascular phase in 3 patients. Of the 23 patients with focal spared lesions, the enhancement pattern was isoenhancement in 18 and hyperenhancement in 5. No hypoechoic areas were noted in the postvascular phase in any patient. The hemodynamics in focal steatosis and focal spared lesions in nondiffuse fatty liver can be observed using low-invasive procedures in real-time by CEUS. It was suggested that differences in the dynamics of enhancement in the vascular phase of CEUS were influenced by the fat deposits in the target lesion, the surrounding liver parenchyma, and the third inflow.

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Incidentally Detected Splenic Lesions in Ultrasound: Does Contrast-Enhanced Ultrasonography Improve the Differentiation of Benign Hemangioma/Hamartoma from Malignant Lesions?

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0031-1282034 ◽

2011 ◽

Vol 32 (06) ◽

pp. 582-592 ◽

Cited By ~ 14

Author(s):

A. Stang ◽

H. Keles ◽

S. Hentschke ◽

C.-U. von Seydewitz ◽

J. Dahlke ◽

...

Keyword(s):

Odds Ratio ◽

Sulfur Hexafluoride ◽

Multivariate Analyse ◽

Contrast Enhanced ◽

Contrast Enhanced Ultrasonography ◽

Malignant Lesions

Zusammenfassung Ziel: Ziele dieser Arbeit waren die Identifikation und die Validierung von unterschiedlichen tumorspezifischen Kontrastmittelmustern für die Differenzialdiagnose zwischen benignen vaskulären Neoplasien (Typ Hämangiom/Hamartom) und malignen Milzherden in der Kontrastmittelsonografie (CEUS). Material und Methoden: 136 Milzläsionen (58 benigne vaskuläre Neoplasien, 78 maligne Läsionen) wurden jeweils in der B-Bild-Sonografie (US) und nachfolgend in der Kontrastmittelsonografie nach Sulfur-Hexafluoride-Injektion untersucht und dokumentiert. Zwei On-site-Reader analysierten das Kontrastmittelverhalten der Milzläsionen während der arteriellen und parenchymalen Phase. Mittels univariater und multivariater Analyse wurden tumorspezifische Kontrastmittelmuster, die signifikant mit einer der beiden Tumordiagnosen korreliert waren, identifiziert. Zwei geblindete Off-site-Reader benutzten diese tumorspezifischen Kontrastmittelmuster als Diagnosekriterien und stellten unabhängig voneinander anhand der Befunde der B-Bild-Sonografie und der Kontrastmittelsonografie eine Diagnose der Milzherde. Die diagnostische Treffsicherheit und Confidence (Az-Werte) sowie die Übereinstimmung der Off-site-Reader (қ-Werte) wurden kalkuliert. Referenzstandards waren Histopathologie oder CT und/oder MRI mit klinischem Verlauf. Ergebnisse: In der multivariate Analyse waren arterielles Hyper- oder Isoenhancement unabhängige Prediktoren für eine benigne vaskuläre Neoplasie (Odds Ratio, 3,558; p < 0,0017). In der Subgruppe der iso- oder hypoechogenen Läsionen war arterielles Hyperenhancement praktisch beweisend für eine benigne vaskuläre Neoplasie (Odds Ratio, 21,333; p < 0,001). In der geblindeten Situation verbesserte sich die diagnostische Treffsicherheit und Confidence (Az-Werte) für beide Off-site Reader signifikant von 63,2 % und 70,6 % (0,785 und 0,818) in der B-Bild-Sonografie auf 87,5 % und 88,2 % (0,915 und 0,908) in der Kontrastmittelsonografie (p < 0,001). Die Interreaderübereinstimmung verbesserte sich ebenfalls (қ = 0,52 für B-Bild-Sonografie vs. қ = 0,88 nach Kontrastmittelsonografie). Schlussfolgerung: Die Kontrastmittelsonografie verbessert die Differenzialdiagnose zwischen benigen vaskulären Neoplasien und malignen Tumoren in der Milz und scheint besonders hilfreich bei unklaren, zufällig im Ultraschall entdeckten hypoechogenen Milzherden.

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