scholarly journals Role of Contrast-Enhanced Ultrasonography in Hepatocellular Carcinoma by Using LI-RADS and Ancillary Features: A Single Tertiary Centre Experience

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2232
Author(s):  
Adriana Ciocalteu ◽  
Sevastita Iordache ◽  
Sergiu Marian Cazacu ◽  
Cristiana Marinela Urhut ◽  
Sarmis Marian Sandulescu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Yield ◽  
High Specificity ◽  
Final Diagnosis ◽  
Focal Liver Lesions ◽  
Liver Imaging ◽  
Tertiary Centre ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Ancillary Features

Clinical utility of ancillary features (AFs) in contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS®) is yet to be established. In this study, we assessed the diagnostic yield of CEUS LI-RADS and AFs in hepatocellular carcinoma (HCC). We retrospectively included patients with risk factors for HCC and newly diagnosed focal liver lesions (FLL). All lesions have been categorized according to the CEUS LI-RADS v2017 by an experienced sonographer blinded to clinical data and to the final diagnosis. From a total of 143 patients with 191 FLL, AFs favoring HCC were observed in 19.8% cases as hypoechoic rim and in 16.7% cases as nodule-in nodule architecture. From the total of 141 HCC cases, 83.6% were correctly classified: 57.4%- LR-5 and 26.2%- LR-4. In 9.21% cases, CEUS indicated LR-M; 2.12% cases- LR-3. The LR-5 category was 96.2% predictive (PPV) of HCC. LR-5 had 60.4% sensitivity and 93.6% specificity. PPV for primitive malignancy (LR-4 + LR-5) was 95.7%, with 88% sensitivity, 89.3% specificity and 88.4% accuracy for HCC. LR-4 category had 94.8% PPV and 26.2% sensitivity. CEUS LR4 + LR5 had 81,8% sensitivity for HCCs over 2 cm and 78.57% sensitivity for smaller HCCs. CEUS LR-5 remains an excellent diagnostic tool for HCC, despite the size of the lesion. The use of AFs might improve the overarching goal of LR-5 + LR-4 diagnosis of high specificity for HCC and exclusion of non-HCC malignancy.

scholarly journals Diagnostic Accuracy of Contrast-enhanced Ultrasonography Liver Imaging Reporting and Data System in Hepatocellular Carcinoma: A Systematic Review

2021 ◽  
Author(s):  
HuiFang Li ◽  
Wei Huang ◽  
Wei Zheng ◽  
Qing Li ◽  
YunZhu Dai ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
At Risk ◽  
Sensitivity And Specificity ◽  
Web Of Science ◽  
Reporting System ◽  
Data System ◽  
Liver Imaging ◽  
Contrast Enhanced ◽  
Patients At Risk ◽  
Contrast Enhanced Ultrasonography

Abstract Background: Contrast-enhanced Ultrasonography Liver Imaging Reporting and Data System (CEUS LI-RADS) released by American College of Radiology was a widely used reporting system for patients at risk with hepatocellular carcinoma (HCC). In CEUS LI-RADS, the categories range from definitely benign (LR-1), probably begin (LR-2), intermediate probability of malignancy (LR-3), probably HCC (LR-4) to definitely HCC (LR-5), malignancy (LR-M), or definite tumor in vein (LR-TIV). Methods: We searched MEDLINE, Web of Science, Cochrane, Embase, and Chinese databases to obtain eligible studies reporting on the diagnostic performance of CEUS LI-RADS in patients at risk for HCC. Results: Twelve studies were eligible in the analysis, including 5275 patients, 5739 observations, and 4066 HCCs. The pooled sensitivity and specificity were 70% (95% Confidence Interval [CI] 65%-74%), 94% (95% CI, 91%-96%) of LR-5 category as predictors of HCC, respectively. The pooled sensitivity and specificity of LR-M category as a predictor of non-HCC malignancy were 83% (95% CI, 71%-91%), 94% (95% CI 88%-97%), respectively. The pooled proportions of HCCs were 1% (95% CI 0%-6%) for LR-2, 20% (95% CI, 9%-34%) for LR-3, 78% (95% CI, 67%-88%) for LR-4, 97% (95% CI, 94%-99%) for LR-5, 40% (95% CI, 23%–58%) for LR-M and 100% (95% CI, 93%–100%) for LR-TIV.Conclusion: CEUS LI-RADS is an important tool for the diagnosis of HCC.

scholarly journals Is There a Place for Elastography in the Diagnosis of Hepatocellular Carcinoma?

2021 ◽  
Vol 10 (8) ◽  
pp. 1710
Author(s):  
Ana-Maria Ghiuchici ◽  
Ioan Sporea ◽  
Mirela Dănilă ◽  
Roxana Șirli ◽  
Tudor Moga ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Shear Wave Elastography ◽  
Abdominal Ultrasound ◽  
Liver Parenchyma ◽  
Final Diagnosis ◽  
Focal Liver Lesions ◽  
Additional Information ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced

Background and Aims: Elastography can provide information regarding tissue stiffness (TS). This study aimed to analyze the elastographic features of hepatocellular carcinoma (HCC) and the factors that influence intratumoral elastographic variability in patients with liver cirrhosis. Methods: This prospective study included 115 patients with liver cirrhosis and hepatocellular carcinoma evaluated between June 2016–November 2019. A total of 88 HCC nodules visualized in conventional abdominal ultrasound (US) met the inclusion criteria and underwent elastographic evaluation. Elastographic measurements (EM) were performed in HCC and liver parenchyma using VTQ (Virtual Touch Quantification), a point shear wave elastography (pSWE) technique. In all patients, we performed contrast-enhanced ultrasound (CEUS), and the final diagnosis of HCC was established by contrast-enhanced-CT or contrast-enhanced-MRI. Results: The mean VTQ values in HCCs were 2.16 ± 0.75 m/s. TS was significantly lower in HCCs than in the surrounding liver parenchyma 2.16 ± 0.75 m/s vs. 2.78 ± 0.92 (p < 0.001). We did not find significant differences between the first five and the last five EM, and the intra-observer reproducibility was excellent ICC: 0.902 (95% CI: 0.87–0.950). However, the tumor size, heterogeneity, and depth correlated with higher intralesional stiffness variability (p < 0.001). Conclusions: VTQ brings additional information for HCC characterization. Intra-observer reproducibility for both HCC and liver parenchyma was excellent. Knowing the stiffness of HCC’s might endorse an algorithm-based approach towards focal liver lesions (FLLs) in liver cirrhosis.

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.

Mo1935 Using Contrast-Enhanced Ultrasonography (CEUS) Time-Intensity Curves (TICs) as Classifiers in Neural Network Diagnosis of Focal Liver Lesions

2012 ◽  
Vol 142 (5) ◽  
pp. S-1004 ◽  
Author(s):  
Costin T. Streba ◽  
Dan Ionut Gheonea ◽  
Larisa D. Sandulescu ◽  
Liliana Streba ◽  
Tudorel Ciurea ◽  
...  
Keyword(s):  
Neural Network ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Network Diagnosis

Clinical efficacy of contrast-enhanced ultrasonography (CEUS) in the diagnosis of ruptured hepatocellular carcinoma (HCC)

2007 ◽  
Vol 34 (2) ◽  
pp. 101-105 ◽  
Author(s):  
Naoki Matsumoto ◽  
Masahiro Ogawa ◽  
Hiroshi Nakagawara ◽  
Yoshikazu Hiroi ◽  
Toshiki Yamamoto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Efficacy ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Ruptured Hepatocellular Carcinoma

MO226A NEW DIAGNOSTIC TOOL FOR CKD PATIENTS: CONTRAST-ENHANCED ULTRASONOGRAPHY. A SINGLE CENTER EXPERIENCE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Mirela Liana Gliga ◽  
Cristian Chirila ◽  
Paula Chirila ◽  
Adriana Gomotarceanu ◽  
Imola Torok ◽  
...  
Keyword(s):  
Diagnostic Tool ◽  
Final Diagnosis ◽  
Medical System ◽  
Focal Lesions ◽  
Non Invasive ◽  
Single Center Experience ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Malignant Lesions ◽  
Guidelines And Recommendations

Abstract Background and Aims Contrast-enhanced ultrasonography (CEUS) is a minimally invasive diagnostic tool available for diagnosing microvascular disturbances in tumors and many vascular pathologies. Unlike other radiological contrast agents, it is completely harmless for CKD patients and therefore it is used for the safe diagnosis of many diffuse or focal pathologies. Method We used CEUS examination in 50 CKD patients for the following pathologies: 10 atypical cysts, 15 liver focal lesions, 2 splenic focal lesions, 3 renal infarcts, 12 kidney focal lesions and 8 other organ involvements. Examination was made using a VOLUSON E8 machine (GE Medical System Kreztechnik GmbH Tiefenbach 15, Austria) with a 3.5 MHz convex array abdominal transducer. 2.4 ml of microbubble contrast-agent was administered intravenously and recording of the results were made for 3-5 minutes after injection. Results Depending on the organ vascular characteristics, contrast enhancement and/or wash-out were suggestive for the final diagnosis. In liver lesions there are three phases and in kidneys, spleen, gallbladder, adenopathies there are two vascular phases. We obtained a very good positive predictive value and sensitivity in detecting malignant lesions. Conclusion According to The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound they are used both for hepatic and Non-Hepatic Applications. Being non-invasive and non-irradiating it could be the main diagnostic examination in CKD population in the future.

scholarly journals Noninvasive Diagnosis of Hepatocellular Carcinoma on Sonazoid-Enhanced US: Value of the Kupffer Phase

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 141
Author(s):  
Hiroshi Takahashi ◽  
Katsutoshi Sugimoto ◽  
Naohisa Kamiyama ◽  
Kentaro Sakamaki ◽  
Tatsuya Kakegawa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Performance ◽  
Late Phase ◽  
Imaging Feature ◽  
Arterial Phase ◽  
Liver Imaging ◽  
Noninvasive Diagnosis ◽  
Contrast Enhanced ◽  
Treatment Naïve ◽  
Hepatic Lesions

The aim of this study was to compare the diagnostic performance of Contrast-Enhanced US Liver Imaging Reporting and Data System (CEUS LI-RADS) version 2017, which includes portal- and late-phase washout as a major imaging feature, with that of modified CEUS LI-RADS, which includes Kupffer-phase findings as a major imaging feature. Participants at risk of hepatocellular carcinoma (HCC) with treatment-naïve hepatic lesions (≥1 cm) were recruited and underwent Sonazoid-enhanced US. Arterial phase hyperenhancement (APHE), washout time, and echogenicity in the Kupffer phase were evaluated using both criteria. The diagnostic performance of both criteria was analyzed using the McNemar test. The evaluation was performed on 102 participants with 102 lesions (HCCs (n = 52), non-HCC malignancies (n = 36), and benign (n = 14)). Among 52 HCCs, non-rim APHE was observed in 92.3% (48 of 52). By 5 min, 73.1% (38 of 52) of HCCs showed mild washout, while by 10 min or in the Kupffer phase, 90.4% (47 of 52) of HCCs showed hypoenhancement. The sensitivity (67.3%; 35 of 52; 95% CI: 52.9%, 79.7%) of modified CEUS LI-RADS criteria was higher than that of CEUS LI-RADS criteria (51.9%; 27 of 52; 95% CI: 37.6%, 66.0%) (p = 0.0047). In conclusion, non-rim APHE with hypoenhancement in the Kupffer phase on Sonazoid-enhanced US is a feasible criterion for diagnosing HCC.

550 DETECTABILITY OF CONTRAST-ENHANCED ULTRASONOGRAPHY USING SONAZOID FOR HEPATOCELLULAR CARCINOMA

2010 ◽  
Vol 52 ◽  
pp. S219-S220
Author(s):  
E. Goto ◽  
R. Masuzaki ◽  
R. Tateishi ◽  
K. Uchino ◽  
T. Arano ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography

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.

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