Corrigendum: Diagnostic Accuracy of Delayed Phase Post Contrast Computed Tomographic Images in the Diagnosis of Focal Liver Lesions in Dogs: 69 Cases

To describe the computed tomographic (CT) features of focal liver lesions (FLLs) in dogs, that could enable predicting lesion histotype. Dogs diagnosed with FLLs through both CT and cytopathology and/or histopathology were retrospectively collected. Ten qualitative and 6 quantitative CT features have been described for each case. Lastly, a machine learning-based decision tree was developed to predict the lesion histotype. Four categories of FLLs - hepatocellular carcinoma (HCC, n = 13), nodular hyperplasia (NH, n = 19), other benign lesions (OBL, n = 18), and other malignant lesions (OML, n = 19) - were evaluated in 69 dogs. Five of the observed qualitative CT features resulted to be statistically significant in the distinction between the 4 categories: surface, appearance, lymph-node appearance, capsule formation, and homogeneity of contrast medium distribution. Three of the observed quantitative CT features were significantly different between the 4 categories: the Hounsfield Units (HU) of the radiologically normal liver parenchyma during the pre-contrast scan, the maximum dimension, and the ellipsoid volume of the lesion. Using the machine learning-based decision tree, it was possible to correctly classify NHs, OBLs, HCCs, and OMLs with an accuracy of 0.74, 0.88, 0.87, and 0.75, respectively. The developed decision tree could be an easy-to-use tool to predict the histotype of different FLLs in dogs. Cytology and histology are necessary to obtain the final diagnosis of the lesions.

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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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Diagnostic Accuracy of CEUS in the Differential Diagnosis of Small (≤ 20 mm) and Subcentimetric (≤ 10 mm) Focal Liver Lesions in Comparison with Histology

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0031-1271114 ◽

2011 ◽

Vol 32 (06) ◽

pp. 593-597 ◽

Cited By ~ 53

Author(s):

D. Strobel ◽

T. Bernatik ◽

W. Blank ◽

A. Schuler ◽

C. Greis ◽

...

Keyword(s):

Differential Diagnosis ◽

Diagnostic Accuracy ◽

Power Doppler ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Eine Hohe ◽

Maligne Tumore

Zusammenfassung Hintergrund: Evaluierung der diagnostischen Treffsicherheit der Kontrastmittelsonografie in der Differenzialdiagnose kleiner Leberläsionen. Material und Methoden: 1349 Patienten mit im B-Bild und Power Doppler unklarem Lebertumor wurden prospektiv mittels KM-Sono multizentrisch mit standardisiertem Protokoll (mechanischer Index < 0,4, Phase/Puls-Inversion-Technik, Sonovue-Bolus-Injektion) untersucht. Die Differenzialdiagnose im KM-Sono basierte auf tumortypischen Vaskularisationsmustern in der arteriellen, portalvenösen Phase und Spätphase (EFSUMB-Leitlinie). 335 Patienten mit fokalen Leberläsionen (FLLs) ≤ 20 mm wurden analysiert. Die Tumorklassifizierung nach KM-Sono wurde mit der Histologie (73,2 %) oder in einigen Fällen mit CT und/oder MRT verglichen. Ergebnisse: Eine definitive Tumordiagnose war in 329 FLLs möglich. Die Enddiagnose der ≤ 20 mm FLLs mit histologischer Sicherung (n = 241) beinhaltete 87 benigne und 154 maligne Tumore. Die diagnostische Treffsicherheit des KM-Sono bei ≤ 20 mm histologisch gesicherten FLLs war 83,8 %. Die KM-Sono identifizierte 144 /154 maligne FLLs (Sensitivität 93,5 %) und 58 /87 benigne FLLs (Spezifität 66,7 %). 24 /241 FLLs blieben nach der KM-Sono unklar (9,9 %). Die KM-Sono klassifizierte 15 /241 FLLs (6,2 %) falsch (12 benigne und 3 maligne FLLs). Die positive Voraussagekraft der KM-Sono bei malignen FLLs war 92,3 %, die negative Voraussagekraft 95,1 %. Von 241 histologisch gesicherten FLLs waren 62 FLLs ≤ 10 mm (diagnostische Treffsicherheit KM-Sono 80,6 %) und 179 FLLs > 10 mm ≤ 20 mm (diagnostische Treffsicherheit KM-Sono 80,6 %). Schlussfolgerung: Die KM-Sonografie hat eine hohe diagnostische Treffsicherheit in der Differenzierung kleiner und kleinster (≤ 1 cm) FLL im klinischen Alltag.

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Efficacy, safety and diagnostic accuracy of ultrasound guided biopsies of focal liver lesions: a single center experience in 214 patients

Zeitschrift für Gastroenterologie ◽

10.1055/s-0031-1295872 ◽

2012 ◽

Vol 50 (01) ◽

Author(s):

F Rahman ◽

PR Galle ◽

AP Barreiros

Keyword(s):

Diagnostic Accuracy ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Single Center ◽

Ultrasound Guided ◽

Single Center Experience

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Fine Needle Aspiration Biopsy for Improving the Diagnostic Accuracy of Cut Needle Biopsy of Focal Liver Lesions

Acta Cytologica ◽

10.1159/000326529 ◽

2003 ◽

Vol 47 (3) ◽

pp. 332-336 ◽

Cited By ~ 29

Author(s):

Alex Vianey Callado França ◽

Helena Maria Giordano Valério ◽

Mirian Trevisan ◽

Cecília Escanhoela ◽

Tiago Sevá-Pereira ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Fine Needle Aspiration ◽

Needle Biopsy ◽

Fine Needle Aspiration Biopsy ◽

Needle Aspiration ◽

Aspiration Biopsy ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Fine Needle ◽

Needle Aspiration Biopsy

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

BioMed Research International ◽

10.1155/2015/193178 ◽

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.

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