scholarly journals Diagnostic Value of CEUS LI-RADS Version 2017 in Differentiating AFP-Negative Hepatocellular Carcinoma from Other Primary Malignancies of the Liver

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2250
Author(s):  
Peihua Wang ◽  
Fang Nie ◽  
Tiantian Dong ◽  
Dan Yang ◽  
Ting Liu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Malignant Tumors ◽  
High Sensitivity ◽  
High Specificity ◽  
Diagnostic Value ◽  
Arterial Phase ◽  
Liver Imaging ◽  
Pathological Findings ◽  
Focal Lesions

Purpose: To explore the diagnostic value of Contrast-enhanced Ultrasound Liver Imaging Reporting and Data System version 2017 (CEUS LI-RADS v2017) in differentiating alpha-fetoprotein (AFP)-negative hepatocellular carcinoma (HCC) from other primary malignancies (OM) of the liver. Methods: The data of 99 patients with primary liver malignant tumors confirmed by surgical pathology and AFP-negative from January 2018 to January 2021 were retrospectively analyzed, and the lesions were divided into 61 cases in the AFP-negative HCC group and 38 cases in the OM group according to the pathological findings, the CEUS features of the lesions were analyzed and the lesions were classified according to the CEUS LI-RADS v2017. Comparison of CEUS features between the two groups was performed using the χ2 test. The sensitivity, specificity, positive predictive value, negative predictive value, and coincidence rate of CEUS LI-RADS v2017 for the diagnosis of AFP-negative HCC and OM were calculated using pathological findings as the gold standard. Results: The differences in features of arterial phase enhancement and wash-out between the HCC and OM groups were statistically significant (p < 0.05). The sensitivity of diagnosing HCC by LR-5 was 62.3% and the specificity was 92.1%. The sensitivity of diagnosing OM by LR-M was 92.1% and the specificity was 83.6%. Conclusions: When AFP is negative in patients with intrahepatic focal lesions, LR-5 has high specificity but low sensitivity in the diagnosis of HCC, and LR-M has high sensitivity and specificity in the diagnosis of OM. CEUS LI-RADS is a tool to differentiate AFP-negative HCC and OM effectively.

scholarly journals Usefulness of Modified CEUS LI-RADS for the Diagnosis of Hepatocellular Carcinoma Using Sonazoid

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 828
Author(s):  
Katsutoshi Sugimoto ◽  
Tatsuya Kakegawa ◽  
Hiroshi Takahashi ◽  
Yusuke Tomita ◽  
Masakazu Abe ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Arterial Phase ◽  
Liver Imaging ◽  
Adrenal Rest Tumor ◽  
Contrast Enhanced ◽  
Rim Enhancement ◽  
Diagnostic Usefulness ◽  
Adrenal Rest ◽  
Sensitivity Specificity

The Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) was introduced for classifying suspected hepatocellular carcinoma (HCC). However, it cannot be applied to Sonazoid. We assessed the diagnostic usefulness of a modified CEUS LI-RADS for HCC and non-HCC malignancies based on sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Patients with chronic liver disease at risk for HCC were evaluated retrospectively. Nodules ≥1 cm with arterial phase hyperenhancement, no early washout (within 60 s), and contrast defects in the Kupffer phase were classified as LR-5. Nodules showing early washout, contrast defects in the Kupffer phase, and/or rim enhancement were classified as LR-M. A total of 104 nodules in 104 patients (median age: 70.0 years; interquartile range: 54.5–78.0 years; 74 men) were evaluated. The 48 (46.2%) LR-5 lesions included 45 HCCs, 2 high-flow hemangiomas, and 1 adrenal rest tumor. The PPV of LR-5 for HCC was 93.8% (95% confidence interval (CI): 82.8–98.7%). The 22 (21.2%) LR-M lesions included 16 non-HCC malignancies and 6 HCCs. The PPV of LR-M for non-HCC malignancies, including six intrahepatic cholangiocarcinomas, was 100% (95% CI: 69.8–100%). In conclusion, in the modified CEUS LI-RADS for Sonazoid, LR-5 and LR-M are good predictors of HCC and non-HCC malignancies, respectively.

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.

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.

Epstein-Barr Virus (EBV)-Encoded RNA: Automated In-Situ Hybridization (ISH) Compared with Manual ISH and Immunohistochemistry for Detection of EBV in Pediatric Lymphoproliferative Disorders

2009 ◽  
Vol 12 (3) ◽  
pp. 195-199 ◽  
Author(s):  
Naim K. Fanaian ◽  
Cynthia Cohen ◽  
Sandra Waldrop ◽  
Jennifer Wang ◽  
Bahig M. Shehata
Keyword(s):  
In Situ Hybridization ◽  
Predictive Value ◽  
Epstein Barr Virus ◽  
High Sensitivity ◽  
High Specificity ◽  
Lymphoproliferative Disorders ◽  
Barr Virus ◽  
Epstein Barr ◽  
Low Sensitivity

Detection of Epstein-Barr virus (EBV) may be achieved by various methods, including EBV-encoded RNA (EBER) in-situ hybridization (ISH) and immunohistochemistry (IHC) for latent membrane protein (LMP-1). We compared novel automated ISH and IHC techniques in pediatric lymphoproliferative disorders with results obtained by manual ISH. Thirty-seven pediatric cases previously studied by manual EBER ISH (including 18 EBER-positive, 15 EBER-negative, and 4 EBER-equivocal cases) were used for the study. Automated EBER ISH and automated LMP-1 IHC were performed using the BondMax autostainer and prediluted EBER probe and EBV cell surface 1 to 4 at 1:50 dilution, respectively. Results of each of the automated techniques for EBV detection were compared with results by manual EBER ISH. Compared with manual EBER ISH as the gold standard, automated ISH had a sensitivity and specificity of 94% and 69%, respectively, accuracy of 83%, positive predictive value (PPV) of 79%, and negative predictive value (NPV) of 90%. Automated IHC had a sensitivity of 44%, specificity of 93%, accuracy of 67%, PPV of 88%, and NPV of 59%. Automated ISH and IHC correlated significantly ( P < 0.045). Automated ISH is useful for diagnosis of EBV-related pediatric neoplasms, being easy to perform and interpret and requiring only the technologist's time to set up and having a high sensitivity and NPV. The automated IHC protocol is of too low sensitivity for routine use, although results show high specificity and PPV.

scholarly journals Correlation of cord blood albumin values with neonatal jaundice in health new-borns: a prospective observational study

2019 ◽  
Vol 6 (2) ◽  
pp. 634
Author(s):  
Jehangir Allam Bhat ◽  
Roshan Ara
Keyword(s):  
Cord Blood ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Mode Of Delivery ◽  
Subsequent Development ◽  
High Sensitivity ◽  
High Specificity ◽  
Observation Study ◽  
Blood Albumin ◽  
Group B

Background: The objective of the present study was to investigate the predictability of pathological jaundice on cord blood albumin values.Methods: It was a prospective observation study conducted in Kurji holy family hospital on 289 healthy new-borns. Babies were divided into two groups. Group A who developed physiological jaundice and group B who developed pathological jaundice. Cord blood albumin was estimated in all new-born who were then followed up-to 5th day of life. Babies who developed jaundice requiring treatment were admitted in NICU for phototherapy. Rest where checked regularly up-to 5th day of life and value recorded on 5th day by estimation of serum albumin.Results: Incidence of pathological hyperalbuminemia in present study was 11.2%. There was statistically significant correlation between cord blood albumin and development of pathological jaundice. Gender, age, mode of delivery and birth weight has no correlation with cord albumin and the subsequent development of jaundice. Cord blood albumin <3.5mg/dl when compared with subsequent development of jaundice has high specificity (83.92%) and negative predictive value (87.35%). Cord blood value of >2.5mg/dl has high sensitivity (97.06%), specificity (99.22%), Positive predictive value (94.29%) and negative predictive value (99.61%) in predicting future development of pathological jaundice.Conclusions: The 87.35% negative predictive value in the present study suggests that in healthy term babies (Cord blood albumin ≤3.5mg/dl) cord serum albumin can help to identify those new-borns who are unlikely to require further evaluation and intervention. These new-borns can be discharged with assurance to parents. Babies with CBA level <2.5mg/dl should be followed more frequently. Thus, this study concludes that cord blood total albumin levels reliably predict the occurrence of pathological hyperalbuminemia.

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 Novel clinical biomarkers in blood and pleural effusion for diagnosing patients with tuberculosis distinguishing from malignant tumor

2021 ◽  
Author(s):  
Jian Wang ◽  
Zhe-Xiang Feng ◽  
Tao Ren ◽  
Wei-Yu Meng ◽  
Imran Khan ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Tumor ◽  
Malignant Tumors ◽  
High Specificity ◽  
Diagnostic Value ◽  
Blood Parameters ◽  
Clinical Indicators ◽  
Clinical Biomarkers ◽  
Specificity And Sensitivity ◽  
Single Marker

Abstract Background Pleural effusion (PE) is a common manifestation of tuberculosis and malignant tumors, but it is difficult to distinguish tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE), especially by non-invasive detection indicators. We aimed to find effective detection indexes in blood and PE for differentiating patients with tuberculosis from a malignant tumor. Methods 815 patients were collected who diagnosed with tuberculosis or cancer at Taihe hospital from 2014 to 2017. 717 patients were found to have PE by thoracoscopy. The clinical characteristics, patients’ blood parameters, and PE indicators information were summarized for analysis. Results The patients with MPE had higher percentages to be bloody and negative of Rivalta test in PE than patients with TPE. Then for clinical indicators, comparing specific parameters in blood, we observed 18 indicators were higher in the TPE group than in the MPE group. On contrast, 12 indicators were higher in the MPE group than in the TPE group (p < 0.01). In addition, in PE tests, we found there were 3 parameters higher in TPE and other 4 parameters higher in MPE patients group (p < 0.01). Then for clinical diagnosing practice, ROC and PCA analysis were applied. Top six relevant indicators with AUC value over 0.70 were screened out: pADA (0.90), pHsCRP (0.79), sMONp (0.75), sHsCRP (0.73), sESR (0.71), and sD-dimer (0.70). Moreover, with the Logistic regression model, a specific combination of 3 biomarkers pADA, sMONp, and sHsCRP could enhance distinguishing tuberculosis from malignant tumor patients with PE (AUC=0.944, 95% CI=0.925-0.964). For the top single marker pADA, we further analyzed its diagnostic function in patients with different group and observed it kept the high specificity and sensitivity. Conclusions The six indicators of pADA, pHsCRP, sMONp, sHsCRP, sESR and sD-dimer showed significant diagnostic value for clinicians. Further, the combination of pADA, sMONp, and sHsCRP has high accuracy for differential diagnosis for the first time. Mostly interestingly, pADA single marker maintained high specificity and sensitivity in patients with different status, which has great value for the rapid and accurate diagnosis of suspected cases.

scholarly journals Gadoxetic acid-enhanced MRI of hepatocellular carcinoma: Diagnostic performance of category-adjusted LR-5 using modified criteria

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242344
Author(s):  
Jae Hyon Park ◽  
Yong Eun Chung ◽  
Nieun Seo ◽  
Jin-Young Choi ◽  
Mi-Suk Park ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Performance ◽  
Arterial Phase ◽  
Liver Imaging ◽  
Gadoxetate Disodium ◽  
Resonance Imaging ◽  
Feature Based ◽  
Increased Sensitivity ◽  
Transitional Phase ◽  
Ancillary Features

The Liver Imaging Reporting and Data System (LI-RADS) is widely adopted for the noninvasive diagnosis of hepatocellular carcinoma (HCC). Herein, possible strategies to improve the diagnostic performance of LR-5 without reducing specificity for HCC were investigated. This retrospective study included 792 patients who underwent gadoxetate disodium-enhanced magnetic resonance imaging. Hepatic observations were categorized according to LI-RADS v2018 and categories were readjusted by upgrading LR4 to LR5 using ancillary features, arterial phase hyperenhancement (APHE) interpreted with subtraction images, indication of no washout when APHE was absent, extension of washout to the transitional phase, and subthreshold growth as a major feature. Based on LI-RADS v2018, LR-5 showed a sensitivity of 71.9% and a specificity of 97.9% for the diagnosis of HCC. Category-readjusted LR-5 after upgrading LR-4 to LR-5 using ancillary features favoring HCC in particular, subthreshold growth as a major feature, extending washout to transitional phase and APHE interpreted using subtraction images showed significantly increased sensitivity (P<0.001) without decreased specificity (Ps>0.05). The sensitivity of LR-5 can be improved without loss of specificity via category readjustment using AFs favoring HCC in particular, subthreshold growth as a major feature, extending washout to transitional phase and APHE interpreted with subtraction images.

Diagnostic Value of a New Sensitive Membrane Based Technique for Instantaneous D-Dimer Evaluation in Patients with Clinically Suspected Deep Venous Thrombosis

1997 ◽  
Vol 77 (04) ◽  
pp. 637-640 ◽  
Author(s):  
Christophe Leroyer ◽  
Martine Escoffre ◽  
Emmanuelle Le Moigne ◽  
Marc Grimaux ◽  
Olivier Cagnioncle ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Predictive Value ◽  
Clinical Signs ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Lower Sensitivity ◽  
Predictive Values ◽  
Study Results ◽  
D Dimer

SummaryBackground: Plasma D-Dimer analysis, using ELISA assays, has demonstrated in previous studies a high sensitivity, suggesting its utility in excluding deep venous thrombosis (DVT). Aim: To assess the performance of a new rapid plasma D-Dimer ELISA measurement in suspected DVT patients with recent clinical signs, not exceeding one week. Methods: A prospective study of patients admitted for a suspected recent DVT. Contrast venography or compression ultrasonography were performed within 24 h of admission. A new membrane based ELISA technique, which uses an immunofiltration and two complementary monoclonal antibodies was tested. Results were expressed as positive or negative. A standard plasma D-Dimer ELISA measurement was also performed. D-Dimer performances were assessed at the end of the study. Results: 265/448 patients had a proven DVT (72 distal, 193 proximal). The sensitivity of the instantaneous method in the diagnosis of overall DVT is 92 ± 3.4% (95% Cl), and specificity is 36.6 ± 6.9%. Positive predictive value is 67.7 ± 4.8% and negative predictive value is 76.1 ± 8.9%. Sensitivity and negative predictive values reach 97.9 and 94.3% in the diagnosis of proximal DVT, but only 76.3 and 79.7% in the diagnosis of distal DVT. Similar results are observed with the standard ELISA method. Conclusion: This new rapid plasma D-Dimer measurement appears highly sensitive, and could substitute the older ELISA methods. Both methods provide lower sensitivity in the case of a distal DVT location.

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