Abstract
Background: Contrast-enhanced ultrasound (CEUS) allows for dynamic analysis of vascularization patterns of unclear hepatic lesions. Our study aimed to evaluate the diagnostic performance of CEUS for further characterizing suspicious liver lesions by comparing findings from CEUS examinations with corresponding histopathology. Methods: Between 2005 and 2016, 160 patients with unclear liver lesions underwent CEUS followed by liver biopsy. All examinations were performed by an experienced consultant radiologist (EFSUMB Level 3) and included native B-mode ultrasound, Color Doppler, and CEUS. A second-generation blood pool contrast agent was applied for CEUS. Results: CEUS was successfully performed in all patients without occurrence of any adverse side effects. CEUS showed a sensitivity of 94.5%, a specificity of 70.6%, a true positive rate of 87.3%, and a true negative rate of 85.7% compared to histopathological results as the reference standard. Conclusions: CEUS represents a safe imaging modality with a high diagnostic accuracy in assessing both—benign and malignant—liver lesions compared to corresponding histopathological results.
Highlights
Hepatocellular carcinoma (HCC) depicts the most common primary hepatic malignancy and the second most lethal cancer entity [1,2]
Contrast-enhanced ultrasound is a frequently used imaging modality that allows for characterizing unclear hepatic lesions by dynamically assessing lesional and parenchymal microperfusion
The findings from the present study demonstrate that Contrast-enhanced ultrasound (CEUS) depicts a valid and reliable method for characterizing suspicious liver lesions of unclear origin into benign or malignant
Summary
Hepatocellular carcinoma (HCC) depicts the most common primary hepatic malignancy and the second most lethal cancer entity [1,2]. Imaging of patients with suspected HCC is of utmost importance and diagnosis is predominantly based on CT or MRI, while biopsy is only performed in indeterminate cases or to define immunologic treatment options [5,6]. The first line imaging tool to screen for HCC lesions in high-risk patients is conventional ultrasound, comprising native B-mode and Color Doppler. Contrast-enhanced ultrasound (CEUS) allows for dynamic analysis of vascularization patterns of unclear hepatic lesions. Our study aimed to evaluate the diagnostic performance of CEUS for further characterizing suspicious liver lesions by comparing findings from CEUS examinations with corresponding histopathology. All examinations were performed by an experienced consultant radiologist (EFSUMB Level 3) and included native B-mode ultrasound, Color Doppler, and CEUS. Conclusions: CEUS represents a safe imaging modality with a high diagnostic accuracy in assessing both—benign and malignant—liver lesions compared to corresponding histopathological results
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