scholarly journals Predictive value of quantitative contrast-enhanced ultrasound in hepatocellular carcinoma recurrence after ablation

2015 ◽  
Vol 21 (36) ◽  
pp. 10418 ◽  
Author(s):  
Yi Gao
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Hepatocellular Carcinoma Recurrence

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.

scholarly journals Contrast-enhanced ultrasound algorithm (ACR CEUS LI-RADSv 2017)– a valuable tool for the noninvasive diagnosis of hepatocellular carcinoma in patients with chronic liver disease

2021 ◽  
Author(s):  
Ana Maria Ghiuchici ◽  
Mirela Dănilă ◽  
Alina Popescu ◽  
Roxana Șirli ◽  
Tudor Moga ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
High Risk ◽  
Predictive Value ◽  
Real Life ◽  
Reference Method ◽  
Focal Liver Lesions ◽  
Noninvasive Diagnosis ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Malignant Lesions

Aims: to evaluate the accuracy of LR-5 category from the latest Contrast-Enhanced Ultrasound algorithm (ACR CEUS LI-RADSv 2017) for the noninvasive diagnosis of hepatocellular carcinoma (HCC), in a real-life cohort of high-risk patients. Material and methods: We retrospectively re-analysed the CEUS studies of 464 focal liver lesions (FLL) in 382 patients at high-risk for HCC (liver cirrhosis of any aetiology, chronic B or C hepatitis with severe fibrosis) using the ACR CEUS LI-RADSv 2017 algorithm. CEUS LI-RADS categories used for the diagnosis of HCC were: CEUS LR-5 (definitely HCC) and CEUS LR-TIV (HCC with macrovascular invasion). Contrast-enhanced CT, contrast-enhanced MRI, or histology were used as diagnostic reference methods to evaluate the CEUS LI-RADS classification of the 464 lesions. Results: According to the reference method, the 464 lesions were classified as follows: 359 HCCs, 68 non-HCC-non-malignant lesions and 37 non-HCC malignant lesions. The diagnostic accuracy of LR-5 category for the diagnosis of hepatocellular carcinoma was 76.9%. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 71.9%, 94.3 %, 97.7% and 49.5%, respectively. Conclusions: LR-5 category from ACR CEUS LI-RADSv 2017 algorithm, has good sensitivity, excellent specificity, and PPV for the diagnosis of HCC. The HCC rate increases from LR-3 to LR-5.

scholarly journals Intraarterial contrast-enhanced ultrasound to predict the short-term tumour response of hepatocellular carcinoma to Transarterial chemoembolization with Lipiodol

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiang Bo ◽  
Han Peng ◽  
Zhu LianHua ◽  
Fei Xiang ◽  
Luo YuKun
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Model ◽  
Predictive Value ◽  
Transarterial Chemoembolization ◽  
Characteristic Curve ◽  
Tumour Response ◽  
Locoregional Therapy ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Corona Enhancement

Abstract Background Transarterial chemoembolization (TACE) is an effective locoregional therapy in hepatocellular carcinoma (HCC). However, it is difficult to predict the tumour response (TR) of TACE intraprocedurally. The aim of this study was to predict the TR after TACE (1–3 months) in HCC patients using intraprocedural intraarterial contrast enhanced ultrasound (IA-CEUS). Methods In this case-control study, consecutive patients who received TACE in our hospital from September 2018 to May 2019 were enrolled. IA-CEUS was performed before and after TACE. Postoperative contrast-enhanced liver MRI was performed 1–3 months after TACE as the gold standard. According to the modified Response Evaluation Criteria in Solid Tumours (mRECIST), ultrasonic manifestations were compared between the complete remission (CR) group and non-CR group by univariate and multivariate analyses. A logistic predictive model was established and validated, and its diagnostic efficiency was evaluated. Results Forty-four patients with sixty-one lesions were enrolled in the study. Multivariate analysis identified, the risk factors as a large lesion diameter (OR: 1.84; 95% confidence interval [CI]: 1.009, 3.080; P = 0.020), a larger dimension of non-enhancing area in superior mesenteric artery (SMA)-CEUS than the size in B-mode ultrasound preoperatively (OR: 3.379; 95% CI: 1.346,8.484; P = 0.010), presence of corona enhancement in hepatic artery (HA)-CEUS postoperatively (OR: 6.642; 95% CI: 1.214, 36.331; P = 0.029), and decreased corona enhancement thickness (per centimetre) postoperatively (OR: 0.025; 95% CI: 0.006,0.718; P = 0.025). The area under the receiver operating characteristic curve (AUROC) of the predictive model was 0.904 (95% CI: 0.804, 0.966; P < 0.001). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 81.08, 91.67, 85.25, 93.75, and 75.86%, respectively. Leave-one-out cross-validation (LOOCV) showed that the accuracy was 77.05%. Conclusions Intraprocedural IA-CEUS can be used to predict the TR in HCC patients after TACE.

Contrast-Enhanced Ultrasound and Computed Tomography Assessment of Hepatocellular Carcinoma after Transcatheter Arterial Chemo-Embolization: A Systematic Review

2016 ◽  
Vol 25 (4) ◽  
pp. 499-507 ◽  
Author(s):  
Cheng-Jeng Tai ◽  
Ming-Te Huang ◽  
Chih-Hsiung Wu ◽  
Chen-Jei Tai ◽  
Yeu-Ching Shi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Predictive Value ◽  
Transarterial Chemoembolization ◽  
Therapeutic Response ◽  
Response Assessment ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
The Mean

Background & Aims: Contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) are used to assess the response of hepatocellular carcinoma after transarterial chemoembolization. Our aim was to perform a systematic review to compare CEUS and CECT for therapeutic response assessment to transarterial chemoembolization in the treatment of hepatocellular carcinoma. Method: PubMed, Embase, and the Cochrane Library databases were searched from inception until January 1, 2016. Participants: patients with hepatocellular carcinoma. Intervention: transarterial chemoembolization and CECT vs CEUS. Results. Sixteen studies were included in the systematic review. The total number of patients was 858 and the mean patient age ranged from 42 to 73 years. The mean tumor size ranged from 1.0 cm to 4.3 cm. The sensitivity and specificity of CEUS ranged from 46% to 100% and 65% to 100%, respectively, and that of CECT ranged from 34% to 87% and 92% to 100%, respectively. The accuracy of CEUS ranged from 72.6% to 100% and that of CECT from 61% to 94%. Marked heterogeneity was present among the studies. Conclusion: CEUS is comparable with CECT for the therapeutic response assessment after transarterial chemoembolization. Abbreviations: CECT: Contrast-enhanced CT; CEUS: Contrast-enhanced Ultrasound; CT: Computed Tomography; HCC: Hepatocellular Carcinoma; MDCT: Multidetector row CT; MRI: Magnetic Resonance Imaging; mRECIST: modified Response Evaluation Criteria in Solid Tumors; NPV: Negative Predictive Value; PPV: Positive Predictive Value; QUADAS-2: Quality Assessment of Diagnostic Accuracy Studies; RFA: Radiofrequency Ablation; TACE: Transcatheter Arterial Chemoembolization.

scholarly journals Real-life assessment of standardized contrast-enhanced ultrasound (CEUS) and CEUS algorithms (CEUS LI-RADS®/ESCULAP) in hepatic nodules in cirrhotic patients—a prospective multicenter study

2021 ◽  
Author(s):  
D. Strobel ◽  
E.-M. Jung ◽  
M. Ziesch ◽  
M. Praktiknjo ◽  
A. Link ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Real Life ◽  
Life Assessment ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Non Invasive ◽  
Contrast Enhanced ◽  
Cirrhotic Patients

Abstract Objectives Hepatocellular carcinoma (HCC) can be diagnosed non-invasively with contrast-enhanced ultrasound (CEUS) in cirrhosis if the characteristic pattern of arterial phase hyperenhancement followed by hypoenhancement is present. Recent studies suggest that diagnosis based on this “hyper-hypo” pattern needs further refinement. This study compares the diagnostic accuracies of standardized CEUS for HCC according to the current guideline definition and following the newly developed CEUS algorithms (CEUS LI-RADS®, ESCULAP) in a prospective multicenter real-life setting. Methods Cirrhotic patients with liver lesions on B-mode ultrasound were recruited prospectively from 04/2018 to 04/2019, and clinical and imaging data were collected. The CEUS standard included an additional examination point after 4–6 min in case of no washout after 3 min. The diagnostic accuracies of CEUS following the guidelines (“hyper-hypo” pattern), based on the examiner’s subjective interpretation (“CEUS subjective”), and based on the CEUS algorithms ESCULAP and CEUS LI-RADS® were compared. Results In total, 470 cirrhotic patients were recruited in 43 centers. The final diagnosis was HCC in 378 cases (80.4%) according to the reference standard (histology 77.4%, MRI 16.4%, CT 6.2%). The “hyper-hypo” pattern yielded 74.3% sensitivity and 63% specificity. “CEUS subjective” showed a higher diagnostic accuracy (sensitivity, 91.5%; specificity, 67.4%; positive predictive value, 92%; negative predictive value, 66%). Sensitivity was higher for ESCULAP (95%) and “CEUS subjective” (91.5%) versus CEUS LI-RADS® (65.2%; p < 0.001). Specificity was highest for CEUS LI-RADS® (78.6%; p < 0.001). Conclusions CEUS has an excellent diagnostic accuracy for the non-invasive diagnosis of HCC in cirrhosis. CEUS algorithms may be a helpful refinement of the “hyper-hypo” pattern defined by current HCC guidelines. Key Points • Contrast-enhanced ultrasound (CEUS) has a high diagnostic accuracy for the non-invasive diagnosis of hepatocellular carcinoma (HCC) in cirrhosis. • The CEUS algorithm ESCULAP (Erlanger Synopsis for Contrast-enhanced Ultrasound for Liver lesion Assessment in Patients at risk) showed the highest sensitivity, whereas the CEUS LI-RADS® (Contrast-Enhanced UltraSound Liver Imaging Reporting and Data System) algorithm yielded the highest specificity. • A standardized CEUS examination procedure with an additional examination point in the late phase, after 4–6 min in lesions with no washout after 3 min, is vital.

Contrast-Enhanced Ultrasound in the Short-Term Evaluation of Hepatocellular Carcinoma after Locoregional Treatment

2020 ◽  
Vol 38 (6) ◽  
pp. 522-533
Author(s):  
Maria Elena Ainora ◽  
Roberto Iezzi ◽  
Francesca Romana Ponziani ◽  
Matteo Garcovich ◽  
Enrico Di Stasio ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Value ◽  
Combined Treatment ◽  
Residual Tumor ◽  
Percutaneous Ethanol Injection ◽  
Locoregional Therapy ◽  
Contrast Enhanced Ultrasound ◽  
Ethanol Injection ◽  
Contrast Enhanced ◽  
Significant Difference

<b><i>Background:</i></b> Contrast-enhanced ultrasound (CEUS) with second-generation contrast agents performed 1 month after hepatocellular carcinoma (HCC) treatment is almost as sensitive as contrast-enhanced computed tomography (CECT) in depicting the residual tumor. However, the efficacy of CEUS performed early after the procedure is still debated. <b><i>Aim:</i></b> We evaluated the diagnostic accuracy (DA) of CEUS for the assessment of tumor response shortly after locoregional therapy in patients with unresectable HCC. <b><i>Methods:</i></b> Ninety-four patients with 104 HCC lesions who were scheduled to receive percutaneous ethanol injection, radiofrequency ablation, transcatheter arterial chemoembolization, or combined treatment were enrolled in this study. With CECT at 1-month as the reference standard, the DA of CEUS performed 48-h after the procedure was evaluated. Patients were followed-up to look for tumor or disease progression. <b><i>Results:</i></b> Based on CECT findings, 43/104 lesions were diagnosed as having residual viability after 1 month. CEUS performed 48 h after treatment detected residual tumor in 34/43 nodules with treatment failure at CECT with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 79.1, 96.7, 94.4, 86.8, and 89%, respectively. There was a high degree of concordance between CEUS and CECT (kappa coefficient = 0.78). A hyperemic halo was detectable in 35 lesions without a statistically significant difference between concordant and discordant cases. In patients with uninodular disease responders according to 48 h CEUS had a significantly longer mean overall survival and time to progression compared to nonresponders. <b><i>Conclusion:</i></b> CEUS performed 48 h after treatment can be considered a reliable modality for the evaluation of the real extent of necrosis and has prognostic value in the assessment of HCC.

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