The diagnostic value of contrast-enhanced ultrasound (CEUS) for assessing hepatocellular carcinoma compared to histopathology; a retrospective single-center analysis of 119 patients#

2020 ◽  
pp. 1-6
Author(s):  
C. Marschner ◽  
L. Zhang ◽  
V. Schwarze ◽  
W. Völckers ◽  
M.F. Froelich ◽  
...  
Keyword(s):  
Color Doppler ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Blood Pool ◽  
Imaging Method ◽  
Mechanical Index ◽  
Single Center ◽  
Experienced Radiologist ◽  
Good Imaging ◽  
Surveillance Programs

BACKGROUND: HCC as the 6th most common tumor entity with the fourth highest mortality and an increasing prevalence especially due to today’s lifestyle acquires a high attention in the clinical setting. Beside CECT and CEMRI, CEUS depicts a dynamic, low-risk and radiation free imaging method that finds its use mainly in screening and active surveillance programs. PURPOSE: The aim of the retrospective study was to evaluate the diagnostic value of CEUS in correlation to pathologic findings. MATERIALS AND METHODS: Between 2004 and 2018 a total number of 119 patients were included in this retrospective single-center study. Every patient underwent CEUS in addition to a native B-mode and Color-Doppler scan. After given informed consent SonoVue® (Bracco, Milan, Italy), a second-generation blood-pool agent, was used as contrast medium. Every examination was performed and interpreted by a single experienced radiologist (EFSUMB level 3). A low mechanical index (MI) of <0,2 was chosen to obtain a good imaging quality. RESULTS: All 119 included patients received CEUS followed by a renal biopsy for inter-modality comparison. In correlation to the pathology results, CEUS showed a diagnostic sensitivity of 96,6%, a specificity of 63,9%, a PPV of 86,7% and a NPV of 88,5% by detecting liver lesions suspicious for HCC. According to the Cohen’s Kappa coefficient (k = 0,659) CEUS shows a strong inter-modality agreement in comparison to the histopathological finding. CONCLUSION: With a high sensitivity and a strong cross-modality comparability to histopathology, the CEUS is highly effective in the detection of suspicious HCC lesions.

The diagnostic performance of contrast-enhanced ultrasound (CEUS) for evaluating hepatocellular carcinoma (HCC) juxtaposed to MRI findings; a retrospective single-center analysis of 292 patients

2020 ◽  
Vol 76 (2) ◽  
pp. 155-160 ◽  
Author(s):  
V. Schwarze ◽  
C. Marschner ◽  
W. Völckers ◽  
G. Negrão de Figueiredo ◽  
J. Rübenthaler ◽  
...  
Keyword(s):  
Primary Liver Cancer ◽  
Color Doppler ◽  
Dynamic Assessment ◽  
Diagnostic Value ◽  
Blood Pool ◽  
Liver Lesions ◽  
Single Center ◽  
Mri Findings ◽  
Experienced Radiologist ◽  
Mri Scans

BACKGROUND: HCC is the most frequent primary liver cancer entity. Major risk factors comprise chronic HBC and HCV infections, ALD or NAFLD. Apart from the anamnesis, the clinical examination and serologic analysis, an essential part of the diagnostic HCC work-up is due to imaging findings from sonography, CT or MRI scans. HCC lesions feature a distinct vascularization pattern: hyperenhancement during early arterial and hypoenhancement/wash-out during portal venous or delayed phases. CEUS facilitates dynamic assessment of microperfusion patterns of suspicious liver lesions. PURPOSE: The purpose of the present retrospective single-center study was to determine the diagnostic value of CEUS for assessing HCC by comparison with findings from MRI scans. MATERIALS AND METHODS: Between 2004-2018 292 patients with suspicious liver lesions underwent CEUS and MRI. All patients underwent native B-mode, Color Doppler and CEUS after given informed consent. The applied contrast agent was a second-generation blood pool agent (SonoVue®, Bracco, Milan, Italy). Every CEUS examination was performed and interpreted by a single experienced radiologist (EFSUMB Level 3). RESULTS: CEUS was performed on all included patients without occurrence of any adverse effects. CEUS showed a sensitivity of 96%, a specificity of 91%, a PPV of 95% and a NPV of 94% for analyzing HCC in comparison with MRI as the diagnostic gold standard. CONCLUSION: With a distinguished safety profile CEUS shows a high diagnostic accuracy in assessing HCC compared to corresponding results from MRI scans.

scholarly journals Contrast-Enhanced Ultrasound (CEUS) for the Evaluation of Bosniak III Complex Renal Cystic Lesions—A 10-Year Specialized European Single-Center Experience with Histopathological Validation

Medicina ◽  
2020 ◽  
Vol 56 (12) ◽  
pp. 692
Author(s):  
Vincent Schwarze ◽  
Johannes Rübenthaler ◽  
Saša Čečatka ◽  
Constantin Marschner ◽  
Matthias Frank Froelich ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Color Doppler ◽  
Blood Pool ◽  
Histopathological Analysis ◽  
Cystic Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Single Center ◽  
Renal Lesions ◽  
Experienced Radiologist ◽  
Contrast Enhanced

Background and objectives: The aim of the present retrospective single-center study is to evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) for assessing Bosniak III complex renal cystic lesions with histopathological validation. Materials and Methods: 49 patients with CEUS-categorized Bosniak III renal cystic lesions were included in this retrospective study. All patients underwent native B-mode, Color Doppler, contrast-enhanced ultrasound (CEUS) between 2010–2020. Eight and five patients underwent computed tomography (CT) and magnetic resonance imaging (MRI), respectively. Twenty-nine underwent (partial) nephrectomy allowing for histopathological analysis. The applied contrast agent for CEUS was a second-generation blood pool agent. Ultrasonography examinations were performed and interpreted by a single experienced radiologist with more than 15 years of experience (EFSUMB Level 3). Results: CEUS examinations were successfully performed in all included patients without registering any adverse effects. The malignancy rate of CEUS-categorized Bosniak III renal lesions accounted for 66%. Initially, cystic complexity was visualized in native B-mode. In none of the renal lesions hypervascularization was detected in Color Doppler. CEUS allowed for detection of contrast enhancement patterns in all included Bosniak III renal lesions. Delayed wash-out could be detected in 6/29 renal lesions. In two cases of histopathologically confirmed clear-cell RCC, appropriate up-grading from Bosniak IIF to III was achieved by CEUS. Conclusions: CEUS depicts a promising imaging modality for the precise diagnostic workup and stratification of renal cystic lesions according to the Bosniak classification system, thereby helping guidance of adequate clinical management in the future.

scholarly journals Evaluation of the Diagnostic Value of Contrast-Enhanced Voiding Urosonography with Regard to the Further Therapy Regime and Patient Outcome—A Single-Center Experience in an Interdisciplinary Uroradiological Setting

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 56
Author(s):  
Constantin A. Marschner ◽  
Vincent Schwarze ◽  
Regina Stredele ◽  
Matthias F. Froelich ◽  
Johannes Rübenthaler ◽  
...  
Keyword(s):  
Gold Standard ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Voiding Cystourethrography ◽  
Single Center ◽  
Clinical Implementation ◽  
Single Center Experience ◽  
Experienced Radiologist ◽  
Contrast Enhanced ◽  
Tract Infections

Background and Objectives: Vesicoureteral reflux (VUR) describes a common pediatric anomaly in pediatric urology with a prevalence of 1–2%. In diagnostics, in addition to the gold standard of voiding cystourethrography (VCUG), contrast-enhanced urosonography (ceVUS) offers a radiation-free procedure, which, despite its advantages, is not yet widely used. In the present single-center study, subsequent therapeutic procedures and outcomes after ceVUS of 49 patients were investigated. The aim of the study is to investigate the efficacy of ceVUS with the intention of broader clinical implementation. Materials and Methods: Between 2016 and 2020, 49 patients were retrospectively included and received a ceVUS to evaluate VUR. With a distribution of 47:2 (95.9%), a clear female predominance was present. The age of the patients varied between 5 months and 60 years at the time of ceVUS. All examinations were all performed and subsequently interpreted by a single experienced radiologist (EFSUMB level 3). Results: Compared to intraoperative findings, ceVUS shows a sensitivity of 95.7% with a specificity of 100%. Allergic reactions to the contrast medium could not be observed. Conclusion: With its high sensitivity and intraoperative validation, ceVUS offers an excellent alternative to VCUG, the gold standard in the diagnosis of VUR. In addition, ceVUS is a radiation-free examination method with a low risk profile that offers an exceptional diagnostic tool in the diagnostic clarification of recurrent urinary tract infections with the suspected diagnosis of VUR and should also be included in the consideration of a diagnosis next to the established VCUG, especially in younger children.

scholarly journals Diagnostic value of contrast-enhanced ultrasound versus computed tomography for hepatocellular carcinoma: a retrospective, single-center evaluation of 234 patients

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052093015 ◽  
Author(s):  
Vincent Schwarze ◽  
Constantin Marschner ◽  
Wiebke Völckers ◽  
Sergio Grosu ◽  
Giovanna Negrão de Figueiredo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Ct Scans ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Single Center ◽  
Experienced Radiologist ◽  
Contrast Enhanced

Objective Hepatocellular carcinoma (HCC) is the most common cause of primary liver cancer. A major part of diagnostic HCC work-up is based on imaging findings from sonography, computed tomography (CT), or magnetic resonance imaging (MRI) scans. Contrast-enhanced ultrasound (CEUS) allows for the dynamic assessment of the microperfusion pattern of suspicious liver lesions. This study aimed to evaluate the diagnostic value of CEUS compared with CT scans for assessing HCC. Methods We performed a retrospective, single-center study between 2004 and 2018 on 234 patients with suspicious liver lesions who underwent CEUS and CT examinations. All patients underwent native B-mode, color Doppler and CEUS after providing informed consent. Every CEUS examination was performed and interpreted by a single experienced radiologist (European Federation of Societies for Ultrasound in Medicine and Biology level 3). Results CEUS was performed on all included patients without occurrence of any adverse effects. CEUS showed a sensitivity of 94%, a specificity of 70%, a positive predictive value of 93% and a negative predictive value of 72% for analyzing HCC compared with CT as the diagnostic gold standard. Conclusions CEUS has an excellent safety profile and shows a high diagnostic accuracy in assessing HCC compared with corresponding results from CT scans.

scholarly journals Diagnostic value of HRCT-Thorax for pandemic COVID-19 pneumonia in Pakistan

2020 ◽  
Vol 24 (Supp-1) ◽  
pp. 77-84
Author(s):  
Abdul Rasheed Qureshi ◽  
Zaheer Akhtar ◽  
Muhammad Irfan ◽  
Muhammad Sajid ◽  
Zeeshan Ashraf
Keyword(s):  
High Sensitivity ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Sudden Onset ◽  
High Resolution Computed Tomography ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Experienced Radiologist ◽  
Variable Extent ◽  
Low Sensitivity

Background: In the scenario of, inadequate testing, the low sensitivity of the COVID-19-PCR test, limited availability of testing kits, and low detection rate, we aimed to investigate the usefulness of high-resolution computed tomography of chest (HRCT) for diagnosing pandemic coronavirus (COVID-19) pneumonia. Objective: To determine the diagnostic efficacy of HRCT thorax in Covid-19 pandemic pneumonia. Materials and Methods: This prospective, cross-sectional study was conducted in the Pulmonology–OPD of Gulab Devi Teaching Hospital, Lahore-Pakistan from 01-04-2020 to 15-07-2020.   121 patients with dry cough, fever, and dyspnea of sudden onset were included while patients with Bronchial Asthma, ILD, Tuberculosis, Bronchiectasis, COPD, and overt heart failure were excluded. Patients were investigated with chest x-ray, HRCT, COVID-PCR, and hematological tests. HRCT films were evaluated by a qualified and experienced radiologist. Findings were summarized, organized and statistical analysis was done by using SPSS-26 software to make an inference. Results: Five patients were diagnosed as non-covid. Out of 116-diagnosed covid-19 patients, 38(32.75%) showed sub-pleural consolidation, 19(16.37%) consolidation with air-bronchogram, 29(25.0%) crazy paving sign, one pleural effusion (0.86%) and 18 cases (15.51%) displayed reticulations. 11cases(9.48%) had isolated ground glass appearances, while all categories showed it to variable extent. 65 patients (56.03%) were PCR-positive while  51(43.96) patients with positive-HRCT findings for COVID-19 pneumonia had negative nasopharyngeal-PCR. HRCT-Thorax revealed sensitivity: 97.41 %, specificity: 80%, PPV: 99.12%, NPV: 57.14%, and diagnostic accuracy of 96.69% for COVID-19 pneumonia. Conclusion: HRCT-Thorax, having high sensitivity and adequate specificity, can provide foundations for evidence-based early diagnosis and quantification of coronavirus pneumonia.  It can be tremendously useful for decision making in   PCR-negative patients and anticipating respiratory improvement or decline by serial scans.

scholarly journals Evaluation of Diagnostic Efficiency of Alpha-Fetoprotein in Patients with Liver Cirrhosis and Hepatocellular Carcinoma: Single-Center Experience

2018 ◽  
Vol 6 (9) ◽  
pp. 1668-1673 ◽  
Author(s):  
Lejla Mehinovic ◽  
Erna Islamagic ◽  
Azra Husic-Selimovic ◽  
Amina Kurtovic-Kozaric ◽  
Zora Vukobrat-Bijedic ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
High Sensitivity ◽  
Serum Levels ◽  
Diagnostic Value ◽  
Diagnostic Efficiency ◽  
Single Center ◽  
Single Center Experience ◽  
Disease Stages ◽  
Tumour Lesion

BACKGROUND: AFP serum levels are considered as diagnostic and specific for hepatocellular carcinoma (HCC) in patients with liver cirrhosis (LC). AIM: This study aimed to examine the diagnostic value of AFP in the distinguishing of patients with HCC from patients with LC, and to analyse the potential correlation between AFP levels and liver disease stages. MATERIAL AND METHODS: Fifty patients with LC and fifty patients with HCC were included in this study. The majority of the patients were males, while the HBV aetiology was dominant. RESULTS: Significant differences between LC and HCC patients were detected for AST, ALT, GGT, bilirubin, AFP and AP. Patients with HCC had higher AFP values compared to LC. There was no significant correlation between the size of the tumour lesion and serum AFP levels. A positive correlation between AFP concentration and GGT activity was determined, as was the negative correlation between AFP and age of the subjects. The AFP value of 23.34 ng/m showed high sensitivity (84%) and specificity (82%). CONCLUSION: The size of the surface below the ROC curve (AUC) was 0.877 (0.80-0.95), which makes AFP a good biomarker and this diagnostic test is sufficient to separate patients with HCC and LC.

scholarly journals Role of ultrasound, Color duplex Doppler and sono-elastography in the evaluation of renal allograft complications

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Abeer Mohammed Abd El-Motaal ◽  
Rasha M. Dawoud ◽  
Mohamed F. Sherif ◽  
Tarek A. Eldiasty
Keyword(s):  
Renal Transplantation ◽  
Renal Allograft ◽  
Color Doppler ◽  
Prognostic Index ◽  
High Sensitivity ◽  
High Specificity ◽  
Imaging Method ◽  
Duplex Doppler ◽  
Stage Renal Disease ◽  
Sensitivity Specificity

Abstract Background Renal transplantation could be considered for patients with end-stage renal disease. Ultrasonography is the imaging method chosen for renal allograft evaluation early in the postoperative period. Sono-elastography is used to estimate tissue stiffness. This study aimed to assess the correlation between sono-elastography and renal allograft histopathology in patients who had transplanted kidney and determine the efficacy of grayscale ultrasound, sono-elastography, and color duplex in evaluation renal allograft complications and correlation with renal function. Results Forty patients (26 males and 14 females) who underwent renal transplantation were included. Their ages ranging from 10:52 years; they all subjected to ultrasound, color Doppler, sono-elastography, and histopathology. The studded patients were divided into 3 groups according to histopathology: patient with normal results, patients with ATI, and patients with CAI. The difference between the mean elasticity values between the three groups was statistically highly significant (p value < 0.001) with high specificity, sensitivity, and accuracy in differentiating ATI and normal groups and also CAI and normal groups, while the lowest sensitivity noticed in differentiating between ATI and CAI groups that is mean elasticity was good to differentiating between ATI and normal groups and also between CAI and normal groups while it was less in differentiating between ATI and CAI groups. As regards the RI, the highest sensitivity of the RI was in differentiating ATI and normal with high sensitivity, specificity, and accuracy, and the lowest sensitivity, specificity, and accuracy of RI were in differentiating CAI and normal groups. Conclusion Transplanted renal allograft could be assessed by combined US, color duplex Doppler, and sono-elastography examination; also we can detect posttransplant complications early. Sono-elastography could be an efficient noninvasive method to diagnose and monitor kidney allograft rejection and follow-up of the renal allograft, which may give a further and possibly earlier prognostic index for chronic dysfunction in addition to serum creatinine.

D-Dimers, Thrombin Antithrombin III Complexes and Prothrombin Fragments 1 + 2: Diagnostic value in Clinically Suspected Deep Vein Thrombosis

1991 ◽  
Vol 65 (01) ◽  
pp. 028-032 ◽  
Author(s):  
B Boneu ◽  
G Bes ◽  
H Pelzer ◽  
P Sié ◽  
H Boccalon
Keyword(s):  
Deep Vein Thrombosis ◽  
Antithrombin Iii ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Predictive Values ◽  
Vein Thrombosis ◽  
High Negative Predictive Value ◽  
Deep Vein ◽  
D Dimer ◽  
Mercury Strain Gauge

SummaryThis study was performed to determine the accuracy of D-Dimer fibrin derivatives, thrombin-antithrombin III (TAT) complexes and prothrombin fragments 1 + 2 (F 1 + 2) determinations for the diagnosis of deep vein thrombosis (DVT). One hundred and sixteen consecutive patients referred to the angiology unit of our hospital for a clinically suspected DVT were investigated. They were submitted to mercury strain gauge plethysmography and to ultrasonic duplex scanning examination; in cases of inconclusive results or of proximal DVT (n = 35), an ascending phlebography was performed. After these investigations were completed, the diagnosis of DVT was confirmed in 34 and excluded in 82. One half of the patients were already under anticoagulant therapy at the time of investigation. The 3 biological markers were assayed using commercially available ELISA techniques and the D-Dimer was also assayed with a fast latex method. The normal distribution of these markers was established in 40 healthy blood donors. The most accurate assay for the diagnosis of DVT was the D-Dimer ELISA which had both a high sensitivity (94%) and a high negative predictive value (95%). The D-Dirner latex, TAT complexes and F 1 + 2 were far less sensitive and provided negative predictive values which ranged between 78 and 85%. In spite of positive and significant correlations between the levels of ihe 3 markers, their association did not improve their overall accuracy for detecting D\/L Therefore, with the exception of the D-Dimer ELISA, these markers were of little value for the diagnosis of DVT in this specific population.

scholarly journals POS1388 ULTRASOUND FOR PANNICULITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 977.1-977
Author(s):  
A. Potapova ◽  
O. Egorova ◽  
O. Alekseeva ◽  
A. Volkov ◽  
S. Radenska-Lopovok
Keyword(s):  
Dynamic Range ◽  
Subcutaneous Fat ◽  
Diagnostic Value ◽  
High Energy ◽  
Contralateral Side ◽  
Imaging Method ◽  
Non Invasive ◽  
M 12

Background:Ultrasound (US) is a non-invasive and safe imaging method that allows in vivo differentiation of the morphological structures of subcutaneous fat (SCF) tissue in in normal and pathology.Objectives:Reveal features of ultrasound changes in SCF in panniculitis (Pn).Methods:57 patients (f – 45, m - 12) aged 18 - 67 years with an initial diagnosis of erythema nodosum and a disease duration of 3.6 ± 1.4 years were examined. In addition to the general clinical examination, a computed tomography of the chest organs and a pathomorphological examination of a skin biopsy from the site of the node were performed. Ultrasound was performed on a MyLabTwice apparatus (ESAOTE, Italy) using a multi-frequency linear transducer (10-18 MHz) with the PD technique, the parameters of which were adapted for recording low-speed flows (PRF 300-600 Hz, low filter, dynamic range - 20-40 dB), the presence of vascularization was assessed not only in the affected area, but also on the contralateral side using high-energy Doppler.Results:33 patients were diagnosed with septal Pn (SPn), 24 - lobular Pn (LPn). In all cases, the diagnosis was verified by histological examination. Ultrasound made it possible to assess the thickness, echoicity and vascularization of the SCF. In 35 patients, significant thickening of the SCF was revealed (as compared to the contralateral side), of which in 14 cases with SPn, in 21 - with LPn. Significant diffuse thickening of the SCF with the contralateral side was observed in 18 patients, incl. in 12 (66%) patients with LPn. Limited thickening was more typical for SPn (73%). A significant increase in the echoicity of the SCF was noted in all forms of Pn. A “lobular” echo pattern with an anechogenic environment was observed in 25 patients, of which 18 (72%) had LPn. An increase in vascularization compared to the contralateral side was recorded in 30 cases (SPn-17, LPn-13).Conclusion:The obtained preliminary results indicate the important role of ultrasound in assessing the depth and prevalence of the inflammatory process at Pn. To clarify the diagnostic value of this method, further studies are needed on a larger sample of patients.Disclosure of Interests:None declared

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