Characterization of Malignant Focal Liver Lesions with Contrast-Enhanced 40 MHz Ultrasound Imaging in Hepatitis B Virus X Transgenic Mice: A Feasibility Study

2008 ◽  
Vol 30 (4) ◽  
pp. 203-216 ◽  
Author(s):  
Ai-Ho Liao ◽  
Ya-Chien Cheng ◽  
Chien-Hsiu Weng ◽  
Ting-Fen Tsai ◽  
Wei-Hsiang Lin ◽  
...  
Keyword(s):  
Transgenic Mice ◽  
Liver Parenchyma ◽  
Liver Lesion ◽  
Focal Liver Lesion ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Preclinical Research ◽  
Post Contrast ◽  
Contrast Enhanced ◽  
B Virus

Contrast-enhanced ultrasound (CEUS) imaging has been a reliable clinical method of detecting three vascular contrast phases and characterizing focal liver lesions. Previous results were all from human (i.e., clinical studies). The main purpose of this study was to extend this to small animals and to investigate the feasibility of using CEUS in preclinical research. Specifically, high-frequency (40 MHz) ultrasound liver imaging with albumin-shelled microbubbles was employed to detect the three vascular contrast phases and characterize focal liver lesions that developed in thirteen Hepatitis B virus X (HBx) transgenic mice at around 14 to 16 months of age. Previous studies indicated that 90–100% incidence of hepatocellular carcinoma (HCC) was observed in HBx transgenic male mice. After injecting the contrast agent, the time-intensity curves (TICs) of focal liver lesions, vessels in focal liver lesions and surrounding liver parenchyma tissues were measured for 30 minutes. The peak of mean intensity relative to the baseline increased 7.36 dB (p<0.02). On the other hand, the mean contrast between the focal liver lesion and the liver parenchyma increased by 7.74 (p<0.05) dB, thus allowing clear detection of the lesion margin. Histopathology investigations confirmed the development of the lesion in these mice. In addition, guidelines of European Federation of Societies for Ultrasound in Medicine and Biology were followed as an attempt to characterize features of the TICs in mice. The arterial phase was defined as 2 to 60 seconds post contrast injection, and the parenchyma phase was defined as the time period from 10 to 30 minutes post contrast injection. Comparing the imaging with the pathology results, the sensitivity, specificity and accuracy of CEUS for the detection of malignant focal liver lesion in HBx transgenic mice were 91%, 100% and 92%. These results demonstrated that high-frequency CEUS imaging potentially can be used for detecting the three vascular contrast phases of malignant focal liver lesions and characterizing malignant focal liver lesions in mice. Thus can be a valuable tool in preclinical research.

scholarly journals Contrast-enhanced ultrasound of benign and malignant liver lesions in children

2021 ◽  
Author(s):  
Cheng Fang ◽  
Sudha A. Anupindi ◽  
Susan J. Back ◽  
Doris Franke ◽  
Thomas G. Green ◽  
...  
Keyword(s):  
Liver Lesion ◽  
Focal Liver Lesion ◽  
Ultrasound Contrast Agents ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Cross Sectional ◽  
Pediatric Liver ◽  
Contrast Enhanced

AbstractContrast-enhanced ultrasound (CEUS) is increasingly being used in children. One of the most common referrals for CEUS performance is characterization of indeterminate focal liver lesions and follow-up of known liver lesions. In this setting, CEUS is performed with intravenous administration of ultrasound contrast agents (UCAs). When injected into a vein, UCA microbubbles remain confined within the vascular network until they dissipate. Therefore, visualization of UCA within the tissues and lesions corresponds to true blood flow. CEUS enables continuous, real-time observation of the enhancement pattern of a focal liver lesion, allowing in most cases for a definite diagnosis and obviating the need for further cross-sectional imaging or other interventional procedures. The recent approval of Lumason (Bracco Diagnostics, Monroe Township, NJ) for pediatric liver CEUS applications has spurred the widespread use of CEUS. In this review article we describe the role of CEUS in pediatric liver applications, focusing on the examination technique and interpretation of main imaging findings of the most commonly encountered benign and malignant focal liver lesions. We also compare the diagnostic performance of CEUS with other imaging modalities for accurate characterization of focal liver lesions.

scholarly journals Effects of Gray-Scale Ultrasonography Immediate Post-Contrast on Characterization of Focal Liver Lesions

2015 ◽  
Vol 2015 ◽  
pp. 1-11
Author(s):  
Wei Yang ◽  
Min-Hua Chen ◽  
Wei Wu ◽  
Ying Dai ◽  
Zhi-Hui Fan
Keyword(s):  
Interventional Procedure ◽  
Hepatic Metastases ◽  
Focal Liver Lesions ◽  
Imaging Features ◽  
Liver Lesions ◽  
Gray Scale ◽  
Post Contrast ◽  
Contrast Enhanced ◽  
Before And After

This study compared the imaging features of conventional gray scale ultrasound (US) before and after contrast-enhanced ultrasound (CEUS) for focal liver lesions and 22 evaluated the role of US post-CEUS in characterizing liver lesions. 126 patients with 158 focal liver lesions underwent CEUS and US post-CEUS examination and entered this study. There were 74 hepatocellular carcinomas (HCC), 43 hepatic metastases, and 41 hemangiomas. Imaging features of US pre-CEUS and US post-CEUS were analyzed offsite by two blinded experienced radiologists to evaluate size, boundary, echogenicity, internal texture, posterior acoustic enhancement, spatial resolution, and contrast resolution. In the end with pathological and clinical evidence, the diagnostic accuracy rate of US pre-CEUS was 53.8% (85/158 lesions), lower than that of CEUS (88.0%, 139/158 lesions); with the complementation of US post-CEUS the rate rose to 93.0% (147/158 lesions). US post-CEUS could improve the visibility of typical structures of focal liver lesions and might provide important complementary information for CEUS diagnosis. It also increases the visibility of small liver lesions compared with US pre-CEUS and helps to guide local interventional procedure.

scholarly journals Deep Neural Architectures for Contrast Enhanced Ultrasound (CEUS) Focal Liver Lesions Automated Diagnosis

Sensors ◽  
2021 ◽  
Vol 21 (12) ◽  
pp. 4126
Author(s):  
Cătălin Daniel Căleanu ◽  
Cristina Laura Sîrbu ◽  
Georgiana Simion
Keyword(s):  
Liver Lesion ◽  
Focal Liver Lesion ◽  
Evaluation Procedure ◽  
Focal Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Biomedical Image Processing ◽  
Biomedical Image ◽  
Cad System ◽  
Image Sensing ◽  
Contrast Enhanced

Computer vision, biomedical image processing and deep learning are related fields with a tremendous impact on the interpretation of medical images today. Among biomedical image sensing modalities, ultrasound (US) is one of the most widely used in practice, since it is noninvasive, accessible, and cheap. Its main drawback, compared to other imaging modalities, like computed tomography (CT) or magnetic resonance imaging (MRI), consists of the increased dependence on the human operator. One important step toward reducing this dependence is the implementation of a computer-aided diagnosis (CAD) system for US imaging. The aim of the paper is to examine the application of contrast enhanced ultrasound imaging (CEUS) to the problem of automated focal liver lesion (FLL) diagnosis using deep neural networks (DNN). Custom DNN designs are compared with state-of-the-art architectures, either pre-trained or trained from scratch. Our work improves on and broadens previous work in the field in several aspects, e.g., a novel leave-one-patient-out evaluation procedure, which further enabled us to formulate a hard-voting classification scheme. We show the effectiveness of our models, i.e., 88% accuracy reported against a higher number of liver lesion types: hepatocellular carcinomas (HCC), hypervascular metastases (HYPERM), hypovascular metastases (HYPOM), hemangiomas (HEM), and focal nodular hyperplasia (FNH).

scholarly journals Prospective assessment of diagnostic efficacy and safety of SonazoidTM and SonoVue® ultrasound contrast agents in patients with focal liver lesions

2021 ◽  
Author(s):  
Ke Lv ◽  
Hongyan Zhai ◽  
Yuxin Jiang ◽  
Ping Liang ◽  
Hui-Xiong Xu ◽  
...  
Keyword(s):  
Contrast Agents ◽  
Liver Lesion ◽  
Similar Efficacy ◽  
Diagnostic Value ◽  
Focal Liver Lesion ◽  
Ultrasound Contrast Agents ◽  
Focal Liver Lesions ◽  
Diagnostic Efficacy ◽  
Post Contrast ◽  
Prospective Assessment

Abstract Objectives To assess the respective diagnostic value of Sonazoid™ and SonoVue® for characterizing FLLs as benign or malignant and the corresponding safety. Methods This prospective Phase 3 study was conducted at 17 centres in China and Korea (May 2014 to April 2015); 424 patients (20 to 80 years) with at least 1 untreated focal liver lesion (FLL) (< 10 cm in diameter) underwent a contrast-enhanced ultrasound (CEUS) examination (218 received Sonazoid of 0.12 μL microbubbles/kg; 206 received SonoVue of 2.4 mL). Three independent blinded readers evaluated pre- and post-contrast images characterising the FLLs as benign or malignant. Results Sonazoid-enhanced and SonoVue-enhanced ultrasound provided a statistically significant improvement in specificity for all 3 readers comparing to unenhanced ultrasound (for Sonazoid: p = 0.0093, < 0.0001, 0.0011; for SonoVue: p = 0.002, 0.03, 0.12, respectively). Difference in accuracy improvement between the 2 groups was within the pre-specified non-inferiority margin of 20% for all 3 readers (6.1%, 95% CI: − 5.0 to 17.2; − 7.5%, 95% CI: − 18.4 to 3.5; − 0.3%, 95% CI: − 11.3 to 10.7). The diagnostic confidence level for all 3 readers increased with post-contrast images relative to pre-contrast images. Both contrast agents were well tolerated. Conclusion Results showed a similar efficacy for Sonazoid™ and SonoVue® in diagnosing FLLs as benign or malignant, and underlined the benefit of CEUS imaging over unenhanced ultrasound imaging in reaching a confident diagnosis without having to refer patients for additional imaging exams.

scholarly journals Contrast-Enhanced Ultrasound LI-RADS LR-5 in Hepatic Tuberculosis: Case Report and Literature Review of Imaging Features

2021 ◽  
Vol 12 (1) ◽  
pp. 1-9
Author(s):  
Antonella Forgione ◽  
Francesco Tovoli ◽  
Matteo Ravaioli ◽  
Matteo Renzulli ◽  
Francesco Vasuri ◽  
...  
Keyword(s):  
Liver Lesion ◽  
Focal Liver Lesion ◽  
Focal Liver Lesions ◽  
Liver Imaging ◽  
Imaging Features ◽  
Contrast Enhanced Ultrasound ◽  
Mri Findings ◽  
Tuberculosis Case ◽  
Contrast Enhanced ◽  
Hepatic Tuberculosis

Background: The liver is involved in disseminated tuberculosis in more than 80% of cases while primary liver involvement is rare, representing <1% of all cases. Hepatic tuberculosis (TB) can be treated by conventional anti-TB therapy; however, diagnosing this disease remains a challenge. The diagnosis might be particularly difficult in patients with a single liver lesion that could be misdiagnosed as a tumor or other focal liver lesions. Although computed tomography (CT) and magnetic resonance imaging (MRI) findings have been described, there is a paucity of literature on contrast-enhanced ultrasound (CEUS) features of hepatic TB. Case Summary: herein, we describe a case of a patient with tuberculous lymphadenopathy and chronic Hepatitis C Virus (HCV)-related liver disease who developed a single macronodular hepatic TB lesion. Due to the finding of a hepatocellular carcinoma (HCC) highly suggestive CEUS pattern, specifically a LR5 category according to the Liver Imaging Reporting and Data System (LI-RADS), and a good response to antitubercular therapy, a non-invasive diagnosis of HCC was made, and the patient underwent liver resection. We also review the published literature on imaging features of hepatic TB and discuss the diagnostic challenge represented by hepatic TB when occurs as a single focal liver lesion. Conclusions: this report shows for the first time that the CEUS pattern of hepatic TB might be misinterpreted as HCC and specific imaging features are lacking. Personal history and epidemiological data are mandatory in interpreting CEUS findings of a focal liver lesion even when the imaging pattern is highly suggestive of HCC.

The value of preoperative computed tomography combined with ultrasound in the investigation of small indeterminate liver lesions in patients with colorectal cancer

2017 ◽  
Vol 58 (11) ◽  
pp. 1288-1293 ◽  
Author(s):  
Mirna Abraham-Nordling ◽  
Emma Öistämö ◽  
Thomas Josephson ◽  
Fredrik Hjern ◽  
Lennart Blomqvist
Keyword(s):  
Colorectal Cancer ◽  
Computed Tomography ◽  
Liver Metastases ◽  
Liver Lesion ◽  
Liver Cyst ◽  
Focal Liver Lesion ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Newly Diagnosed ◽  
Work Up

Background Computed tomography (CT) is used routinely for the preoperative detection of colorectal cancer (CRC) metastases. When small indeterminate focal liver lesions are detected that are too small to characterize (TSTC) on CT, additional imaging is usually needed, resulting in a potential delay in obtaining a complete diagnostic work-up. Purpose To determine the diagnostic accuracy of ultrasound (US) of the liver performed in direct conjunction to CT in the preoperative investigation among patients with newly diagnosed CRC when indeterminate liver lesions were found on CT. Material and Methods Preoperative investigations with CT and consecutive US where CT had shown at least one focal liver lesion in 74 patients diagnosed with CRC between June 2009 and February 2012 were retrospectively reviewed. Either histopathological findings or a combination of imaging and clinical follow-up one to three years after surgery was used as the reference. Results Liver metastases were diagnosed with CT/US in 13 out of 74 patients (17.6%). In one patient, a liver cyst was preoperatively regarded as liver metastasis by a combined CT/US. The sensitivity and specificity for the CT with consecutive US procedure was 100% (13/13) and 98.4% (60/61). Conclusion US performed in conjunction with CT in patients with indeterminate focal liver lesions on CT is an accurate work-up for detection of liver metastases in patients with newly diagnosed CRC. Although our results are promising, they cannot be considered safely generalizable to all hospitals.

scholarly journals Qualitative And Quantitative Magnetic Resonance Imaging Assessment Of Focal Liver Lesions: A Study To Evaluate The Role Of Different MRI Sequences.

2021 ◽  
Vol 9 (1) ◽  
pp. 27-27
Author(s):  
obaid ashraf ◽  
naseer choh ◽  
omair shah
Keyword(s):  
Tissue Characterization ◽  
Liver Lesion ◽  
Focal Liver Lesion ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Adc Value ◽  
Qualitative And Quantitative ◽  
Diffusion Weighted ◽  
Mri Sequences ◽  
Malignant Lesions

Background: Focal liver lesions have a broad differential diagnosis. MRI with its improved soft tissue characterization and newer sequences can significantly narrow the differentials especially when discriminating benign from malignant lesions. Methods: T1, T1 IN AND OUT OF PHASE, T2, LONG TE T2 AND Diffusion Weighted Imaging was done in 159 patients with USG documented focal liver lesion. Qualitative and quantitative assessment of ADC values and long TE images was done and a threshold for differentiating benign from malignant lesions was obtained. The MRI diagnosis was compared with final diagnosis obtained from histopathology in most cases or follow up and other tests (markers and RBC scan) were histopathology was not available. Sensitivity, specificity and accuracy of MRI sequences in differentiating various focal lesions were obtained. Results: T1 weighted images were useful for identifying fat, hemorrhage and iron within the lesions. T2 weighted imaging was able to correctly classify 82.0% lesions as malignant and 83.7% lesions as benign. Long TE T2 images were highly accurate in distinguishing haemangiomas and cysts from solid lesions. On diffusion-weighted (DW) imaging, 89.5% (i.e. 60 out of 67) lesions were correctly classified as malignant and 88.0% (i.e. 81 out of 92) lesions were correctly classified as benign. Threshold ADC value of 1.37 × 10-3 mm2/s is highly accurate for differentiating malignant from benign lesions. Conclusion: DWI is a sine qua non in liver lesion assessment allowing improved detection and characterization. Long TE T2 weighted imaging can accurately detect haemangiomas and cysts and rule out metastasis.

scholarly journals Characterization of a hepatic haemangioma with contrast-enhanced ultrasound in an infant

Ultrasound ◽  
2017 ◽  
Vol 26 (3) ◽  
pp. 178-181 ◽  
Author(s):  
Marta Anna Piorkowska ◽  
Rok Dezman ◽  
Maria E Sellars ◽  
Annamaria Deganello ◽  
Paul S Sidhu
Keyword(s):  
Imaging Techniques ◽  
Paediatric Population ◽  
Liver Lesion ◽  
Focal Liver Lesion ◽  
Focal Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Safe Alternative ◽  
Contrast Enhanced ◽  
Hepatic Haemangioma

Focal liver lesions are uncommon in the paediatric population, majority are benign but need to be clearly identified as benign. Contrast-enhanced ultrasound has recently received approval for paediatric hepatic use and represents an inexpensive and safe alternative to computed tomography and magnetic resonance imaging for focal liver lesion characterization. We report a case of an incidental focal liver lesion in a four-month-old infant, indeterminate on B-mode ultrasound but successfully characterized with contrast-enhanced ultrasound as a haemangioma, without recourse to other imaging techniques, and with minimal patient discomfort.

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.

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