Diagnostic performance of intravascular perfusion based contrast-enhanced ultrasound LI-RADS in the evaluation of hepatocellular carcinoma

2021 ◽  
pp. 1-9
Author(s):  
Dongsheng Zuo ◽  
Kefeng Yang ◽  
Size Wu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Performance ◽  
Focal Liver Lesions ◽  
Liver Imaging ◽  
Diagnostic Efficiency ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Predictive Values ◽  
Contrast Enhanced ◽  
Sensitivity Specificity

BACKGROUND: The contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) is a relative new algorithm for hepatocellular carcinoma (HCC) assessment. OBJECTIVE: To validate the diagnostic efficiency of the intravascular perfusion based CEUS LI-RADS for HCC. METHODS: Archives of 873 patients with focal liver lesions (FLLs) undergoing CEUS were reviewed, and target images were read by two sonologists independently according to the CEUS LI-RADS. The diagnostic performance was calculated and compared. RESULTS: Assessment with reference to CEUS LI-RADS, 87 of 218 FLLs (39.9%) were categorized as LR-5, 131 of 218 FLLs (60.1%) were categorized as non-LR-5, 19 of 99 HCCs were categorized as non-LR-5, and 7 of 119 non-HCCs were categorized as LR-5. The sensitivity, specificity, AUROC, positive and negative predictive values of CEUS LI-RADS for diagnosing HCC were 80.81%(95%CI: 71.7%–88.0%), 94.1%(95%CI: 88.3%–97.6%), 0.87 (95%CI: 0.82–0.92), 91.9%(95%CI: 84.1%–96.7%), and 85.5%(95%CI: 78.3%–91.0%), respectively. CONCLUSIONS: The diagnostic efficiency of the intravascular perfusion based CEUS LI-RADS for the evaluation of HCCs is very good.

Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System in Diagnosing Hepatocellular Carcinoma: Diagnostic Performance and Interobserver Agreement

2020 ◽  
Author(s):  
Hang Zhou ◽  
Chao Zhang ◽  
Linyao Du ◽  
Jiapeng Jiang ◽  
Qing Zhao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Diagnostic Performance ◽  
Data System ◽  
Liver Imaging ◽  
Contrast Enhanced Ultrasound ◽  
High Risk Patients ◽  
Contrast Enhanced ◽  
Sensitivity Range ◽  
Risk Patients

Abstract Objectives To determine the diagnostic performance and inter-reader agreement of the contrast-enhanced ultrasound liver imaging reporting and data system (CEUS-LI-RADS) for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. Methods In this prospective study, CEUS-LI-RADS categories (LR-5 for predicting HCC) were assigned by six blinded readers and compared to the definitive HCC diagnosis in patients with liver cirrhosis per the 2017 China Liver Cancer Guidelines (CLCG). CEUS features were recorded in 96 patients with 96 histology-proven lesions. The diagnostic performance of LR-5 was described by the sensitivity, specificity and accuracy. Multi-reader agreement was assessed by using intraclass correlation coefficients (ICC). Results In cirrhotic patients, the specificity of LR-5 (range: 92.7–100.0 %) was statistically higher than that of CLCG for each reader (range: 28.6–64.3 %). However, the sensitivity (range: 38.6–63.6 %) and accuracy (range: 53.4–70.7 %) were statistically lower in CEUS-LIRADS than in CLCG (sensitivity range: 88.6–100.0 %; accuracy range: 77.6–86.2 %). Only fair to moderate inter-reader agreement was achieved for the CEUS-LI-RADS category (ICC = 0.595) and washout appearance (ICC range: 0.338 to 0.555). Neither nodule-in-nodule nor mosaic architecture was observed more often in HCC (all P > 0.05), with poor inter-reader consistency for both (both ICC < 0.20). Conclusion CEUS-LI-RADS category 5 has a high specificity but a low accuracy for identifying HCC in high-risk patients. Inter-reader agreement is not satisfactory concerning CEUS-LIRADS category and washout appearance. Moreover, the clinical value of ancillary features favoring HCC is quite limited.

Diagnostic performance of contrast-enhanced ultrasound for complex cystic focal liver lesions: blinded reader study

2008 ◽  
Vol 19 (2) ◽  
pp. 358-369 ◽  
Author(s):  
Man-Xia Lin ◽  
Hui-Xiong Xu ◽  
Ming-De Lu ◽  
Xiao-Yan Xie ◽  
Li-Da Chen ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Blinded Reader

scholarly journals Alteration of contrast enhanced ultrasound (CEUS) of hepatocellular carcinoma in patients with cirrhosis and transjugular intrahepatic portosystemic shunt (TIPS)

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Johannes Chang ◽  
Alexia Dumitrache ◽  
Nina Böhling ◽  
Jasmin Abu-Omar ◽  
Carsten Meyer ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Gold Standard ◽  
Diagnostic Performance ◽  
Portosystemic Shunt ◽  
Arterial Phase ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Intrahepatic Portosystemic Shunt

AbstractTransjugular intrahepatic portosystemic shunt (TIPS) can treat portal hypertensive complications and modifies hepatic hemodynamics. Modification of liver perfusion can alter contrast enhancement dynamics of liver nodules. This study investigated the diagnostic performance of contrast-enhanced ultrasound (CEUS) to diagnose hepatocellular carcinoma (HCC) in cirrhosis with TIPS. In this prospective monocentric observational study, CEUS was used to characterize focal liver lesions in patients at risk for HCC with and without TIPS. Times of arterial phase hyperenhancement (APHE) und washout were quantified. Perfusion-index (PI) and resistance-index (RI) of hepatic artery and portal venous flow parameters were measured via doppler ultrasonography. Diagnostic gold standard was MRI/CT or histology. This study included 49 liver lesions [23 TIPS (11 HCC), 26 no TIPS (15 HCC)]. 26 were diagnosed as HCC by gold standard. Sensitivity and specificity of CEUS to diagnose HCC with and without TIPS were 93.3% and 100% vs. 90.9% and 93.3%, respectively. APHE appeared significantly earlier in patients with TIPS compared to patients without TIPS. TIPS significantly accentuates APHE of HCC in CEUS. CEUS has good diagnostic performance for diagnosis of HCC in patients with TIPS.

scholarly journals Detection and characterization of small superficially located focal liver lesions by contrast-enhanced ultrasound with high frequency transducers

2017 ◽  
Vol 19 (4) ◽  
pp. 349 ◽  
Author(s):  
Wen-Ping Wang ◽  
Yi Dong ◽  
Jiaying Cao ◽  
Feng Mao ◽  
Yadan Xu ◽  
...  
Keyword(s):  
High Frequency ◽  
Low Frequency ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Frequency Transducer ◽  
High Frequency Transducer ◽  
Sensitivity Specificity

Aim: To evaluate the benefits of contrast-enhanced ultrasound (CEUS) with high frequency transducers in the detection and characterization of small superficially located focal liver lesions (FLLs).Material and methods: From January 2015 to October 2016, 27 superficial FLLs detected by MRI were examined, first with the low frequency convex transducer (1-5 MHz) and afterwards with a high frequency transducer (7.5-12 MHz). High frequency dynamic CEUS was performed after a bolus injection of 2.4 ml SonoVue®. FLLs were confirmed by histopathology after surgery (n=18) or ultrasound guided 18-gauge core-needle biopsy (n=8), or by MRI follow-up (n =1).Results: The mean diameter of FLLs was 10.5±3.1 mm, and meandepth was 6.2±5.3 mm. While using a high frequency transducerthe detection rate of FLLs (100%, 27/27) was significantly higher than low frequency transducer (25.9%, 7/27) (p<0.05). The overall sensitivity, specificity and diagnostic accuracy were significantly improved by CEUS with a high frequency transducer (sensitivity 88.9%; specificity 92.6%; accuracy 96.2%).Conclusion: Combining CEUS with the performance of high-frequency transducers is a promising technique to improve the detection and accurate diagnosis of small and superficial FLLs appearing indistinctive on BMUS.

scholarly journals A Nomogram Based on Combining Clinical Features and Contrast Enhanced Ultrasound LI-RADS Improves Prediction of Microvascular Invasion in Hepatocellular Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Hang Zhou ◽  
Jiawei Sun ◽  
Tao Jiang ◽  
Jiaqi Wu ◽  
Qunying Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Model ◽  
Clinical Features ◽  
Diagnostic Performance ◽  
Clinical Information ◽  
Microvascular Invasion ◽  
Liver Imaging ◽  
Contrast Enhanced Ultrasound ◽  
Training Cohort ◽  
Contrast Enhanced

PurposesTo establish a predictive model incorporating clinical features and contrast enhanced ultrasound liver imaging and reporting and data system (CEUS LI-RADS) for estimation of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients.MethodsIn the retrospective study, 127 HCC patients from two hospitals were allocated as training cohort (n=98) and test cohorts (n=29) based on cutoff time-point, June 2020. Multivariate regression analysis was performed to identify independent indicators for developing predictive nomogram models. The area under receiver operating characteristic (AUC) curve was also determined to establish the diagnostic performance of different predictive models. Corresponding sensitivities and specificities of different models at the cutoff nomogram value were compared.ResultsIn the training cohort, clinical information (larger tumor size, higher AFP level) and CEUS LR-M were significantly correlated with the presence of MVI (all p&lt;0.05). By incorporating clinical information and CEUS LR-M, the predictive model (LR-M+Clin) achieved a desirable diagnostic performance (AUC=0.80 and 0.84) in both cohorts at nomogram cutoff score value of 89. The sensitivity of LR-M+Clin when predicting MVI in HCC patients was higher than that of the clinical model alone (86.7% vs. 46.7%, p=0.027), while specificities were 78.6% and 85.7% (p=0.06), respectively, in the test cohort. In addition, LR-M+Clin exhibited similar AUC and specificity, but a significantly higher sensitivity (86.7%) than those of LR-M alone and LR-5(No)+Clin (both sensitivities=73.3%, both p=0.048).ConclusionThe predictive model incorporating CEUS LR-M and clinical features was able to predict the MVI status of HCC and is a potential reliable preoperative tool for informing treatment.

Tumor size-based validation of contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) 2017 for hepatocellular carcinoma characterizing

2021 ◽  
Vol 94 (1126) ◽  
pp. 20201359
Author(s):  
Jia-Min Pan ◽  
Wei Chen ◽  
Yan-Ling Zheng ◽  
Mei-Qing Cheng ◽  
Dan Zeng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Performance Comparison ◽  
Data System ◽  
Liver Imaging ◽  
Contrast Enhanced Ultrasound ◽  
Chi Square ◽  
Liver Nodules ◽  
Contrast Enhanced ◽  
Significant Difference ◽  
Sensitivity Specificity

Objectives: To validate the efficacy of contrast-enhanced ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) and its major features in diagnosing hepatocellular carcinoma (HCC) of different sizes in high-risk patients. Methods: Between January 2014 and December 2015, a total of 545 untreated liver nodules were included. These liver nodules were divided into two groups (<20 mm and ≥20 mm). Each nodule was classified based on CEUS LI-RADS. The diagnostic performance comparison was assessed by the chi-square test, with pathology results as the golden criterion. Results: The accuracy, sensitivity, specificity, and positive predictive value (PPV) of CEUS LR-5 criteria in <20 mm group vs ≥20 mm group in diagnosing HCC were 60.5% vs 59.8%, 55.6% vs 57.6%, 85.7% vs 88.6 and 95.2% vs 98.5%, respectively, without significant difference (all p > 0.05). The accuracy, sensitivity and PPV of LR5/M for malignancy in <20 mm group were lower than in ≥20 mm group, with values of 79.1% vs 95.0%, 84.2% vs 95.7 and 91.4% vs 99.2%, respectively (p < 0.05). Conclusions: The CEUS LI-RADS has a comparable performance for diagnosing HCC between lesions ≥ 20 mm and <20 mm. For diagnosing malignancy including HCC, it has a higher efficacy for lesions ≥ 20 mm than <20 mm. Advances in knowledge: 1.For diagnosing HCC, CEUS LI-RADS has comparable performances between lesions ≥ 20 mm and <20 mm. 2. For diagnosing malignancy including HCC, CEUS LI-RADS has a higher efficacy for lesions ≥ 20 mm than <20 mm.

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