Contrast-Enhanced Ultrasonography for Screening and Diagnosis of Hepatocellular Carcinoma: A Case Series and Review of the Literature

Background: Contrast-enhanced ultrasound (CEUS) is a safe and noninvasive imaging technique that can characterize and evaluate liver lesions, and has been approved for this use in the Unites States since 2016. CEUS has been shown to be similar in accuracy to computed tomography (CT) and magnetic resonance imaging (MRI) for noninvasive diagnosis of hepatocellular carcinoma (HCC) and offers several advantages in certain patient populations who have contraindications for CT or MRI. However, CEUS has inherent limitations and has not been widely employed for evaluation of HCC. Methods: We present three retrospective cases of liver lesions in patients with cirrhosis, who underwent screening for HCC using concurrent, well-timed CT and CEUS. Results: In these cases, the liver lesions were better visualized and then diagnosed as malignancy via CEUS, whereas the lesions were best appreciated on CT only in retrospect. Conclusions: In some cirrhotic patients, a focal lesion may be more easily identifiable via CEUS than on CT and thus accurately characterized, suggesting an important and complementary role of CEUS with CT or MRI. Further studies are indicated to support the use of CEUS for the diagnosis and characterization of liver lesions in screening patients at risk for developing HCC.

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

10.21203/rs.3.rs-379866/v1 ◽

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.

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

Gastroenterology ◽

10.1016/s0016-5085(12)63888-8 ◽

2012 ◽

Vol 142 (5) ◽

pp. S-1004 ◽

Cited By ~ 1

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

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

Journal of Medical Ultrasonics ◽

10.1007/s10396-007-0136-0 ◽

2007 ◽

Vol 34 (2) ◽

pp. 101-105 ◽

Cited By ~ 7

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

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988 EVALUATION OF LOCAL RECURRENCE AFTER TREATMENT FOR HEPATOCELLULAR CARCINOMA BY CONTRAST-ENHANCED ULTRASONOGRAPHY: COMPARISON WITH DYNAMIC COMPUTED TOMOGRAPHY AND/OR MAGNETIC RESONANCE IMAGING

Journal of Hepatology ◽

10.1016/s0168-8278(11)60990-2 ◽

2011 ◽

Vol 54 ◽

pp. S393-S394

Author(s):

A. Martin-Algibez ◽

I. Fernandez-Vazquez ◽

C. Lopez-Martinez ◽

M.S. Gallego-Gallego ◽

R. San Roman ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Hepatocellular Carcinoma ◽

Magnetic Resonance ◽

Local Recurrence ◽

Dynamic Computed Tomography ◽

Resonance Imaging ◽

Contrast Enhanced ◽

Contrast Enhanced Ultrasonography

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

Journal of Hepatology ◽

10.1016/s0168-8278(10)60552-1 ◽

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

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Evaluation of Contrast-Enhanced Intraoperative Ultrasound in the Detection and Management of Liver Lesions in Patients with Hepatocellular Carcinoma

Journal of Oncology ◽

10.1155/2019/6089340 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Cristina Pace ◽

Vittorio Nardone ◽

Silvia Roma ◽

Fabrizio Chegai ◽

Luca Toti ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Intraoperative Ultrasound ◽

Preoperative Imaging ◽

Liver Lesions ◽

Therapy Decision ◽

Contrast Enhanced ◽

Regenerative Nodules ◽

Malignant Liver

Aim. To evaluate the role of contrast-enhanced intraoperative ultrasound (CE-IOUS) during liver surgery in the detection and management of liver lesions in patients with hepatocellular carcinoma (HCC). Materials and Methods. From December 2016 to December 2017, 50 patients with HCC, who were candidates for liver resection, were evaluated with intraoperative ultrasound (IOUS). For all patients, MRI and/or CT were performed before surgery. During surgery, IOUS was performed after liver mobilization, and when nodules that had not been detected in the preoperative MRI and/or CT were observed, CE-IOUS scans were carried out with the dual purpose of better characterizing the unknown lesion and discovering new lesions. Results. In 12 patients, IOUS showed 14 nodules not detected by preoperative MRI and/or CT, before surgery. Out of the 12 lesions, five presented vascular features compatible with those of malignant HCC to the evaluation with CE-IOUS and four of these were simultaneously treated with intraoperative radiofrequency ablation (RFA). The fifth lesion was resected by the surgeon. The remaining nine lesions recognized by IOUS were evaluated as benign at CE-IOUS and considered regenerative nodules. The last diagnosis was confirmed during follow-up obtained by means of CT and/or MRI after 1, 3, 6, or 12 months. Conclusion. In our experience, CE-IOUS is a useful diagnostic tool in both benign pathologies, such as regenerative nodules, and malignant liver lesions. The advantage of this approach is the possibility of intraoperatively characterizing, based on vascularization patterns, lesions that could not be diagnosed by preoperative imaging, resulting in modification of the surgical therapy decision and expansion of the resection or intraoperative ablation.

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Use of Contrast-Enhanced Ultrasonography for the Characterization of Tumor Thrombi in Seven Dogs

Animals ◽

10.3390/ani10091613 ◽

2020 ◽

Vol 10 (9) ◽

pp. 1613

Author(s):

Alessia Cordella ◽

Pascaline Pey ◽

Nikolina Linta ◽

Manuela Quinci ◽

Marco Baron Toaldo ◽

...

Keyword(s):

Color Doppler ◽

Case Series ◽

Arterial Phase ◽

Retrospective Case ◽

Primary Tumors ◽

Contrast Enhanced ◽

Venous Phase ◽

Contrast Enhanced Ultrasonography ◽

Tumor Thrombi

Tumors of adrenal and thyroid glands have been associated with vascular invasions—so-called tumor thrombi, both in humans and dogs. The detection and characterization of venous thrombi is an important diagnostic step in patients with primary tumors for both surgical planning and prognosis. The aim of this study was to describe the use of contrast-enhanced ultrasonography (CEUS) for the characterization of tumor thrombi. Dogs with tumor thrombus who underwent bi-dimensional ultrasound (B-mode US) and CEUS were included. Seven dogs were enrolled in this retrospective case series. On B-mode US, all thrombi were visualized, and vascular distension and thrombus-tumor continuity were seen in three and two cases, respectively. On color Doppler examination, all thrombi were identified, seemed non-occlusive and only two presented vascularity. On CEUS, arterial-phase enhancement and washout in the venous phase were observed in all cases. Non-enhancing areas were identified in the tumor thrombi most likely representing non-vascularized tissue that could potentially be embolized in the lungs after fragmentation of the tumor thrombi. On the basis of these preliminary study, CEUS appeared to be useful for the characterization of malignant intravascular invasion.

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