The application of contrast‐enhanced ultrasound for the characterization of hepatic tumors: An assessment focusing on hepatocellular carcinoma

Abstract

There are only limited applications of contrast‐enhanced ultrasound (CEUS) in Taiwan. We aimed to report our initial experience of CEUS in the diagnosis of hepatic tumors, focusing on hepatocellular carcinoma (HCC). From September 2015 to January 2017, 126 patients were recruited for CEUS using Definity at Tainan Municipal Hospital for the evaluation of hepatic tumors. Of the 126 patients with 64 pathology‐proven liver lesions, 61 were studied. The enhancement patterns of the liver nodules were evaluated according to the 2012 World Federation for Ultrasound in Medicine and Biology and European Federation of Societies for Ultrasound in Medicine and Biology (WFUMB‐EFSUMB) guidelines. The diagnostic value of CEUS was assessed using histopathological results as reference standards and was compared with those of dynamic computed tomography (CT) and magnetic resonance imaging (MRI). The sensitivity, specificity, accuracy, and positive and negative predictive values of CEUS in the HCC diagnosis were 73.6%, 90.9%, 76.6%, and 97.5% and 41.7%, respectively. In terms of diagnostic accuracy of HCC, the discordance between CEUS and dynamic CT/MRI was not statistically significant (P = 0.76). Higher body mass index (>25 kg/m2) showed a significantly negative association with the typical HCC enhancement pattern on CEUS (P = 0.017). No adverse events related to the ultrasound contrast agent were found in the study. From researchers' initial experience, CEUS with Definity contrast agent can be safely and effectively applied in the diagnosis of HCC. Further investigations based on more cases of liver tumors are still warranted.