Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

DOI: 10.1148/radiol.2322031401
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Quaia, E.
Right arrow Articles by Pozzi-Mucelli, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Quaia, E.
Right arrow Articles by Pozzi-Mucelli, R.
(Radiology 2004;232:420-430.)
© RSNA, 2004

Ultrasonography

Characterization of Focal Liver Lesions with Contrast-specific US Modes and a Sulfur Hexafluoride–filled Microbubble Contrast Agent: Diagnostic Performance and Confidence1

Emilio Quaia, MD, Fabrizio Calliada, MD, Michele Bertolotto, MD, Sandro Rossi, MD, Lorena Garioni, MD, Laura Rosa, MD and Roberto Pozzi-Mucelli, MD

1 From the Department of Radiology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, Trieste 34149, Italy (E.Q., M.B., R.P.M.); and Department of Radiology (F.C., L.G.) and Operative Unit of Interventional Ultrasound (S.R., L.R.), San Matteo Hospital, University of Pavia, Italy. From the 2003 RSNA scientific assembly. Received August 31, 2003; revision requested November 11; revision received November 17; accepted January 15, 2004. Address correspondence to E.Q. (e-mail: equaia@yahoo.com).

PURPOSE: To assess whether characterization of solid focal liver lesions could be improved by using ultrasonographic (US) contrast-specific modes after sulfur hexafluoride–filled microbubble contrast agent injection, as compared with lesion characterization achieved with preliminary baseline US.

MATERIALS AND METHODS: Four hundred fifty-two solid focal hepatic lesions that were considered indeterminate at baseline gray-scale and color Doppler US were examined after microbubble contrast agent injection performed by using low-acoustic-power contrast-specific modes during the arterial (10–40 seconds after injection), portal venous (50–90 seconds after injection), and late (100–300 seconds after injection) phases. Two readers independently and retrospectively reviewed baseline and contrast material–enhanced US scans and classified each depicted lesion as malignant or benign according to standard diagnostic criteria. Sensitivity, specificity, accuracy, and positive and negative predictive values and areas under the receiver operating characteristic curve (Az) were calculated by considering histologic analysis (317 patients) or contrast-enhanced helical computed tomography followed by serial US 3–6 months apart (135 patients) as the reference standards.

RESULTS: Different contrast enhancement patterns were observed according to lesion characteristics. During the late phase, benign lesions were predominantly hyper- or isoechoic relative to the adjacent liver parenchyma, whereas malignant lesions were predominantly hypoechoic. Review of the contrast-enhanced US scans after baseline image review yielded significantly improved diagnostic performance (P < .05). Overall diagnostic accuracy was 49% before versus 85% after review of the contrast-enhanced scan for reader 1 and 51% before versus 88% after review of the contrast-enhanced scan for reader 2. Diagnostic confidence—that is, the Az—was 0.820 before versus 0.968 after review of the contrast-enhanced scan for reader 1 and 0.831 before versus 0.978 after review of the contrast-enhanced scan for reader 2.

CONCLUSION: The use of contrast-specific modes with a sulfur hexafluoride contrast agent led to improved characterization of solid focal liver lesions.

© RSNA, 2004

Index terms: Liver neoplasms, 761.3192, 761.3194, 761.3198, 761.321, 761.323, 761.33 • Liver neoplasms, diagnosis, 761.30 • Liver neoplasms, US, 761.12981, 761.12983, 761.12984, 761.12988, 761.12989 • Microbubbles • Ultrasound (US), contrast media, 761.12988




This article has been cited by other articles:


Home page
 Ann. Surg. Oncol.Home page
T. Takayama, M. Makuuchi, M. Kojiro, G. Y. Lauwers, R. B. Adams, S. R. Wilson, H.-J. Jang, C. Charnsangavej, and B. Taouli
Early Hepatocellular Carcinoma: Pathology, Imaging, and Therapy
Ann. Surg. Oncol., April 1, 2008; 15(4): 972 - 978.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
G.-J. Liu, M.-D. Lu, X.-Y. Xie, H.-X. Xu, Z.-F. Xu, Y.-L. Zheng, J.-Y. Liang, and W. Wang
Real-time Contrast-Enhanced Ultrasound Imaging of Infected Focal Liver Lesions
J. Ultrasound Med., April 1, 2008; 27(4): 657 - 666.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
L. Chami, N. Lassau, D. Malka, M. Ducreux, S. Bidault, A. Roche, and D. Elias
Benefits of Contrast-Enhanced Sonography for the Detection of Liver Lesions: Comparison with Histologic Findings
Am. J. Roentgenol., March 1, 2008; 190(3): 683 - 690.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
H.-X. Xu, X.-Y. Xie, M.-D. Lu, G.-J. Liu, Z.-F. Xu, J.-Y. Liang, and L.-D. Chen
Unusual Benign Focal Liver Lesions: Findings on Real-time Contrast-Enhanced Sonography
J. Ultrasound Med., February 1, 2008; 27(2): 243 - 254.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
T. K. Kim, H.-J. Jang, P. N. Burns, J. Murphy-Lavallee, and S. R. Wilson
Focal Nodular Hyperplasia and Hepatic Adenoma: Differentiation with Low-Mechanical-Index Contrast-Enhanced Sonography
Am. J. Roentgenol., January 1, 2008; 190(1): 58 - 66.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
B. Lanka, H.-J. Jang, T. K. Kim, P. N. Burns, and S. R. Wilson
Impact of Contrast-Enhanced Ultrasonography in a Tertiary Clinical Practice
J. Ultrasound Med., December 1, 2007; 26(12): 1703 - 1714.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
E. Quaia, M. D'Onofrio, P. Cabassa, F. Vecchiato, S. Caffarri, F. Pittiani, K. M. Wittkowski, and M. A. Cova
Diagnostic Value of Hepatocellular Nodule Vascularity After Microbubble Injection for Characterizing Malignancy in Patients with Cirrhosis
Am. J. Roentgenol., December 1, 2007; 189(6): 1474 - 1483.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
H.-J. Jang, T. K. Kim, P. N. Burns, and S. R. Wilson
Enhancement Patterns of Hepatocellular Carcinoma at Contrast-enhanced US: Comparison with Histologic Differentiation
Radiology, September 1, 2007; 244(3): 898 - 906.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
M.-H. Chen, W. Wu, W. Yang, Y. Dai, W. Gao, S.-S. Yin, and K. Yan
The Use of Contrast-Enhanced Ultrasonography in the Selection of Patients With Hepatocellular Carcinoma for Radio Frequency Ablation Therapy
J. Ultrasound Med., August 1, 2007; 26(8): 1055 - 1063.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
L. Greenbaum, P. Burns, J. Copel, D. Cosgrove, J. B. Fowlkes, B. Goldberg, R. Mattrey, D. Merton, M. Robbin, and S. Wilson
American Institute of Ultrasound in Medicine Recommendations for Contrast-Enhanced Liver Ultrasound Imaging Clinical Trials
J. Ultrasound Med., June 1, 2007; 26(6): 705 - 716.
[Full Text] [PDF]

Home page
 J Ultrasound MedHome page
O. Catalano, V. Migaleddu, E. Quaia, and G. Caruso
Terminology for Contrast-Enhanced Sonography: A Practical Glossary
J. Ultrasound Med., June 1, 2007; 26(6): 717 - 730.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
K. Numata, H. Oka, M. Morimoto, K. Sugimori, R. Kunisaki, H. Nihonmatsu, K. Matsuo, Y. Nagano, A. Nozawa, and K. Tanaka
Differential Diagnosis of Gallbladder Diseases With Contrast-Enhanced Harmonic Gray Scale Ultrasonography
J. Ultrasound Med., June 1, 2007; 26(6): 763 - 774.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
S. R. Wilson, H.-J. Jang, T. K. Kim, and P. N. Burns
Diagnosis of Focal Liver Masses on Ultrasonography: Comparison of Unenhanced and Contrast-Enhanced Scans
J. Ultrasound Med., June 1, 2007; 26(6): 775 - 787.
[Abstract] [Full Text] [PDF]

Home page
 Br. J. Radiol.Home page
G-J Liu, H-X Xu, M-D Lu, X-Y Xie, Z-F Xu, Y-L Zheng, and J-Y Liang
Correlation between enhancement pattern of hepatocellular carcinoma on real-time contrast-enhanced ultrasound and tumour cellular differentiation on histopathology
Br. J. Radiol., May 1, 2007; 80(953): 321 - 330.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
G. Torzilli, A. Palmisano, D. Del Fabbro, M. Marconi, M. Donadon, A. Spinelli, P. P. Bianchi, and M. Montorsi
Contrast-Enhanced Intraoperative Ultrasonography During Surgery for Hepatocellular Carcinoma in Liver Cirrhosis: Is It Useful or Useless? A Prospective Cohort Study of Our Experience
Ann. Surg. Oncol., April 1, 2007; 14(4): 1347 - 1355.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
O. Catalano, F. Sandomenico, A. Nunziata, M. M. Raso, P. Vallone, and A. Siani
Transient Hepatic Echogenicity Difference on Contrast-Enhanced Ultrasonography: Sonographic Sign and Pitfall
J. Ultrasound Med., March 1, 2007; 26(3): 337 - 345.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
E. Leen, P. Ceccotti, C. Kalogeropoulou, W. J. Angerson, S. J. Moug, and P. G. Horgan
Prospective multicenter trial evaluating a novel method of characterizing focal liver lesions using contrast-enhanced sonography.
Am. J. Roentgenol., June 1, 2006; 186(6): 1551 - 1559.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
E. Quaia, A. Palumbo, S. Rossi, F. Degobbis, S. Cernic, G. Tona, and M. Cova
Comparison of visual and quantitative analysis for characterization of insonated liver tumors after microbubble contrast injection.
Am. J. Roentgenol., June 1, 2006; 186(6): 1560 - 1570.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
M. Valentino, C. Serra, G. Zironi, C. De Luca, P. Pavlica, and L. Barozzi
Blunt Abdominal Trauma: Emergency Contrast-Enhanced Sonography for Detection of Solid Organ Injuries.
Am. J. Roentgenol., May 1, 2006; 186(5): 1361 - 1367.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
S. R. Wilson and P. N. Burns
An Algorithm for the Diagnosis of Focal Liver Masses Using Microbubble Contrast-Enhanced Pulse-Inversion Sonography.
Am. J. Roentgenol., May 1, 2006; 186(5): 1401 - 1412.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
H.-X. Xu, G.-J. Liu, M.-D. Lu, X.-Y. Xie, Z.-F. Xu, Y.-L. Zheng, and J.-Y. Liang
Characterization of Small Focal Liver Lesions Using Real-time Contrast-Enhanced Sonography: Diagnostic Performance Analysis in 200 Patients.
J. Ultrasound Med., March 1, 2006; 25(3): 349 - 361.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
S. Rossi, L. Rosa, V. Ravetta, A. Cascina, P. Quaretti, A. Azzaretti, P. Scagnelli, C. Tinelli, P. Dionigi, and F. Calliada
Contrast-enhanced versus conventional and color Doppler sonography for the detection of thrombosis of the portal and hepatic venous systems.
Am. J. Roentgenol., March 1, 2006; 186(3): 763 - 773.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
H.-X. Xu, M.-D. Lu, G.-J. Liu, X.-Y. Xie, Z.-F. Xu, Y.-L. Zheng, and J.-Y. Liang
Imaging of Peripheral Cholangiocarcinoma With Low-Mechanical Index Contrast-Enhanced Sonography and SonoVue: Initial Experience
J. Ultrasound Med., January 1, 2006; 25(1): 23 - 33.
[Abstract] [Full Text] [PDF]

Home page
 J Ultrasound MedHome page
G. Ferraioli, A. Di Sarno, C. Coppola, and A. Giorgio
Contrast-Enhanced Low-Mechanical-Index Ultrasonography in Hepatic Splenosis
J. Ultrasound Med., January 1, 2006; 25(1): 133 - 136.
[Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
C. Nicolau, R. Vilana, V. Catala, L. Bianchi, R. Gilabert, A. Garcia, and C. Bru
Importance of Evaluating All Vascular Phases on Contrast-Enhanced Sonography in the Differentiation of Benign from Malignant Focal Liver Lesions
Am. J. Roentgenol., January 1, 2006; 186(1): 158 - 167.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
RADIOLOGY RADIOGRAPHICS RSNA JOURNALS ONLINE
Copyright © 2004 by the Radiological Society of North America.