Characterization of Focal Liver Lesions using Contrast Enhanced Ultrasound as a First Line Method: a Large Monocentric Experience

Aim: To present a large monocentric experience in the characterization of focal liver lesions (FLLs) using Contrast Enhanced Ultrasound (CEUS).Method: A retrospective study was performed in the Gastroenterology and Hepatology Department, Timisoara, including 1100 patients with 1329 FLLs evaluated between September 2009 and January 2013. A CEUS examination was considered conclusive if the FLL respected the typical enhancement pattern as described in the EFSUMB Guidelines.Results: From the 1329 FLLs, CEUS was conclusive for a specific pathology in 1102 cases (82.9%). For the differentiation of benign/malignant lesions, CEUS reached a conclusive diagnosis in 1196 (90%) cases. The percentage of conclusive CEUS examinations was significantly higher in patients without chronic liver disease as compared with those with chronic hepatopathies: 87.3% vs. 74.4% (p<0.0001).Conclusion: CEUS patterns of enhancement fell into clear cut specific diagnostic patterns in 83% of the FLLs discovered by US, and into clear cut benign versus malignant patterns in 90% of the cases. For this reason, we can strongly recommend CEUS as a first line imaging method to characterize FLLs found at US, at least in centers with a good experience in CEUS.

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Contrast Enhanced Ultrasound As First Line Imaging Method for the Evaluation of Focal Liver Lesions - A Large Monocentric Experience

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2013.02.383 ◽

2013 ◽

Vol 39 (5) ◽

pp. S81

Author(s):

I. Sporea ◽

A. Martie ◽

A. Popescu ◽

R. Sirli ◽

M. Danila ◽

...

Keyword(s):

Focal Liver Lesions ◽

Imaging Method ◽

Liver Lesions ◽

Contrast Enhanced Ultrasound ◽

First Line ◽

Contrast Enhanced ◽

Line Imaging

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Contrast-Enhanced Ultrasound of Benign Focal Liver Lesions

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-0668-5746 ◽

2018 ◽

Vol 40 (01) ◽

pp. 12-29 ◽

Cited By ~ 1

Author(s):

Christoph Dietrich

Keyword(s):

Liver Tumors ◽

Diagnostic Workup ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Contrast Enhanced Ultrasound ◽

First Line ◽

Benign Liver Tumors ◽

Contrast Enhanced ◽

Line Imaging ◽

Benign Liver

AbstractThe diagnostic handling of benign focal liver lesions (FLLs) is a challenge and it is difficult to avoid over- and underdiagnosis. Conventional B-mode ultrasound and contrast-enhanced ultrasound (CEUS) are the first-line imaging methods to detect and characterize FLLs. This CME article discusses the diagnostic workup of benign liver tumors.

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Contrast-Enhanced Ultrasound for the Characterization of Malignant versus Benign Focal Liver Lesions in a Prospective Multicenter Experience – The SRUMB Study

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-180 ◽

2019 ◽

Vol 28 ◽

pp. 191-196

Author(s):

Ioan Sporea ◽

Daniela Larisa Săndulescu ◽

Roxana Şirli ◽

Alina Popescu ◽

Mirela Danilă ◽

...

Keyword(s):

Predictive Value ◽

Real Life ◽

Daily Practice ◽

Focal Liver Lesions ◽

Imaging Method ◽

Liver Lesions ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Line Imaging

Aim: This study evaluated the accuracy of contrast-enhanced ultrasound (CEUS) for the differential diagnosis of benign vs. malignant focal liver lesions (FLL) in a real-life, multicenter experience. Methods: This prospective study, including 14 Romanian centers, was performed over a 6 year period (February 2011- April 2017) and included 2062 FLLs assessed by CEUS. Inclusion criteria were: newly diagnosed FLL on B-mode ultrasound, less than three lesions/patient, all FLLs evaluated by CEUS and by a second-line imaging technique (contrast enhanced CT or contrast enhanced MRI) or histology, considered as reference. The trial was registered in clinicaltrials.gov (Identifier NCT01329458). Results: From the 2062 FLLs included in the study, 57.2% (1179) were malignant and 42.8% (883) were benign. CEUS had 83.9% sensitivity (Se), 97.8% specificity (Sp), 98.1% positive predictive value (PPV), 82.2% negative predictive value (NPV) and a diagnostic accuracy (Ac) of 89.9% for the positive diagnosis of malignant lesions. For the benign lesions, CEUS had 97.8% Se, 83.9% Sp, 82.2% PPV, 98.1% NPV 89.9% Ac. The diagnostic performance of CEUS for hepatocellular carcinoma was 76.6% Se, 98.4% Sp, and 91.2% Ac; for hemangioma: 89.2% Se, 99% Sp, and 96.9% Ac and for metastases: 90.9% Se, 98.4% Sp, and 96.9% Ac. Conclusions: CEUS proved a high accuracy in differentiating the malignant vs. benign character of a FLL. It can be confidently used as a first line imaging method in daily practice.

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