Skip to main content
Top
Published in: European Radiology 4/2007

01-04-2007 | Hepatobiliary-Pancreas

Characterization of focal liver lesions: comparative study of contrast-enhanced ultrasound versus spiral computed tomography

Authors: V. Catala, C. Nicolau, R. Vilana, M. Pages, L. Bianchi, M. Sanchez, C. Bru

Published in: European Radiology | Issue 4/2007

Login to get access

Abstract

The purpose of this study was to compare the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) with spiral computed tomography (SCT) for the characterization of focal liver lesions (FLL) and to determine the degree of correlation between the two techniques. Seventy-seven FLL (45 hepatocellular carcinomas; 12 metastases; ten hemangiomas; two regenerating/dysplastic nodules; eight focal nodular hyperplasias) detected with ultrasound (US) were prospectively evaluated by CEUS using a second-generation contrast agent and SCT (with an interval of no more than one month between the two techniques). Independent observers made the most probable diagnosis and the results were compared with the final diagnoses (histology n = 59; MRI n = 18). Statistical analysis was performed by the Chi-square and Kappa tests. CEUS provided a correct, specific diagnosis in 69/77 (90%) of the FLL, while SCT did so in 67/77 (87%). The sensitivity, specificity, and diagnostic accuracy for malignancy were 91%, 90%, and 91%, respectively, for CEUS and 88%, 89%, and 88%, respectively, for SCT. No statistically significant difference was found between CEUS and SCT in the characterization of FLL (p > 0.05). In addition, agreement between the two imaging techniques was good (k = 0.75). We conclude that CEUS and SCT provide a similar diagnostic accuracy in the characterization of FLL, with a good degree of correlation between the two techniques.
Literature
1.
go back to reference Karhunen PJ (1986) Benign hepatic tumours and tumour like conditions in men. J Clin Pathol 39(2):183–188PubMedCrossRef Karhunen PJ (1986) Benign hepatic tumours and tumour like conditions in men. J Clin Pathol 39(2):183–188PubMedCrossRef
2.
go back to reference Tanaka S, Kitamura T, Fujita M, Nakanishi K, Okuda S (1990) Color Doppler flow imaging of liver tumors. AJR Am J Roentgenol 154(3):509–514PubMed Tanaka S, Kitamura T, Fujita M, Nakanishi K, Okuda S (1990) Color Doppler flow imaging of liver tumors. AJR Am J Roentgenol 154(3):509–514PubMed
3.
go back to reference Reinhold C, Hammers L, Taylor CR, Quedens-Case CL, Holland CK, Taylor KJ (1995) Characterization of focal hepatic lesions with duplex sonography: findings in 198 patients. AJR Am J Roentgenol 164(5):1131–1135PubMed Reinhold C, Hammers L, Taylor CR, Quedens-Case CL, Holland CK, Taylor KJ (1995) Characterization of focal hepatic lesions with duplex sonography: findings in 198 patients. AJR Am J Roentgenol 164(5):1131–1135PubMed
4.
go back to reference Gaiani S, Casali A, Serra C, Piscaglia F, Gramantieri L, Volpe L, Siringo S, Bolondi L (2000) Assessment of vascular patterns of small liver mass lesions: value and limitation of the different Doppler ultrasound modalities. Am J Gastroenterol 95(12):3537–3546PubMedCrossRef Gaiani S, Casali A, Serra C, Piscaglia F, Gramantieri L, Volpe L, Siringo S, Bolondi L (2000) Assessment of vascular patterns of small liver mass lesions: value and limitation of the different Doppler ultrasound modalities. Am J Gastroenterol 95(12):3537–3546PubMedCrossRef
5.
go back to reference Kubota K, Hisa N, Fujiwara Y, Fukumoto M, Yoshida D, Yoshida S (2000) Evaluation of the intratumoral vasculature of hepatocellular carcinoma by power doppler sonography: advantages and disadvantages versus conventional color doppler sonography. Abdom Imaging 25(2):172–178PubMedCrossRef Kubota K, Hisa N, Fujiwara Y, Fukumoto M, Yoshida D, Yoshida S (2000) Evaluation of the intratumoral vasculature of hepatocellular carcinoma by power doppler sonography: advantages and disadvantages versus conventional color doppler sonography. Abdom Imaging 25(2):172–178PubMedCrossRef
6.
go back to reference Kamel IR, Choti MA, Horton KM, Braga HJ, Birnbaum BA, Fishman EK, Thompson RE, Bluemke DA (2003) Surgically staged focal liver lesions: accuracy and reproducibility of dual-phase helical CT for detection and characterization. Radiology 227(3):752–757PubMedCrossRef Kamel IR, Choti MA, Horton KM, Braga HJ, Birnbaum BA, Fishman EK, Thompson RE, Bluemke DA (2003) Surgically staged focal liver lesions: accuracy and reproducibility of dual-phase helical CT for detection and characterization. Radiology 227(3):752–757PubMedCrossRef
7.
go back to reference Bonaldi VM, Bret PM, Reinhold C, Atri M (1995) Helical CT of the liver: value of an early hepatic arterial phase. Radiology 197(2):357–363PubMed Bonaldi VM, Bret PM, Reinhold C, Atri M (1995) Helical CT of the liver: value of an early hepatic arterial phase. Radiology 197(2):357–363PubMed
8.
go back to reference van Leeuwen MS, Noordzij J, Feldberg MA, Hennipman AH, Doornewaard H (1996) Focal liver lesions: characterization with triphasic spiral CT. Radiology 201(2):327–336PubMed van Leeuwen MS, Noordzij J, Feldberg MA, Hennipman AH, Doornewaard H (1996) Focal liver lesions: characterization with triphasic spiral CT. Radiology 201(2):327–336PubMed
9.
go back to reference Nino-Murcia M, Olcott EW, Jeffrey RB Jr, Lamm RL, Beaulieu CF, Jain KA (2000) Focal liver lesions: pattern-based classification scheme for enhancement at arterial phase CT. Radiology 215(3):746–751PubMed Nino-Murcia M, Olcott EW, Jeffrey RB Jr, Lamm RL, Beaulieu CF, Jain KA (2000) Focal liver lesions: pattern-based classification scheme for enhancement at arterial phase CT. Radiology 215(3):746–751PubMed
10.
go back to reference Nicolau C, Vilana R, Catala V, Bianchi L, Gilabert R, Garcia A, Bru C (2006) Importance of evaluating all vascular phases on contrast-enhanced sonography in the differentiation of benign from malignant focal liver lesions. AJR Am J Roentgenol 186(1):158–167PubMedCrossRef Nicolau C, Vilana R, Catala V, Bianchi L, Gilabert R, Garcia A, Bru C (2006) Importance of evaluating all vascular phases on contrast-enhanced sonography in the differentiation of benign from malignant focal liver lesions. AJR Am J Roentgenol 186(1):158–167PubMedCrossRef
11.
go back to reference Kim TK, Choi BI, Han JK, Hong HS, Park SH, Moon SG (2000) Hepatic tumors: contrast agent-enhancement patterns with pulse-inversion harmonic US. Radiology 216(2):411–417PubMed Kim TK, Choi BI, Han JK, Hong HS, Park SH, Moon SG (2000) Hepatic tumors: contrast agent-enhancement patterns with pulse-inversion harmonic US. Radiology 216(2):411–417PubMed
12.
go back to reference Dill-Macky MJ, Burns PN, Khalili K, Wilson SR (2002) Focal hepatic masses: enhancement patterns with SH U 508A and pulse-inversion US. Radiology 222(1):95–102PubMedCrossRef Dill-Macky MJ, Burns PN, Khalili K, Wilson SR (2002) Focal hepatic masses: enhancement patterns with SH U 508A and pulse-inversion US. Radiology 222(1):95–102PubMedCrossRef
13.
go back to reference Leen E (2001) The role of contrast-enhanced ultrasound in the characterisation of focal liver lesions. Eur Radiol 11(Suppl 3):E27–E34PubMedCrossRef Leen E (2001) The role of contrast-enhanced ultrasound in the characterisation of focal liver lesions. Eur Radiol 11(Suppl 3):E27–E34PubMedCrossRef
14.
go back to reference Bartolotta TV, Midiri M, Quaia E, Bertolotto M, Galia M, Cademartiri F, Lagalla R, Cardinale AE (2005) Benign focal liver lesions: spectrum of findings on SonoVue-enhanced pulse-inversion ultrasonography. Eur Radiol 15(8):1643–1649PubMedCrossRef Bartolotta TV, Midiri M, Quaia E, Bertolotto M, Galia M, Cademartiri F, Lagalla R, Cardinale AE (2005) Benign focal liver lesions: spectrum of findings on SonoVue-enhanced pulse-inversion ultrasonography. Eur Radiol 15(8):1643–1649PubMedCrossRef
15.
go back to reference Leen E, Angerson WJ, Yarmenitis S, Bongartz G, Blomley M, Del Maschio A, Summaria V, Maresca G, Pezzoli C, Llull JB (2002) Multi-centre clinical study evaluating the efficacy of SonoVue (BR1), a new ultrasound contrast agent in Doppler investigation of focal hepatic lesions. Eur J Radiol 41(3):200–206PubMedCrossRef Leen E, Angerson WJ, Yarmenitis S, Bongartz G, Blomley M, Del Maschio A, Summaria V, Maresca G, Pezzoli C, Llull JB (2002) Multi-centre clinical study evaluating the efficacy of SonoVue (BR1), a new ultrasound contrast agent in Doppler investigation of focal hepatic lesions. Eur J Radiol 41(3):200–206PubMedCrossRef
16.
go back to reference Tanaka S, Ioka T, Oshikawa O, Hamada Y, Yoshioka F (2001) Dynamic sonography of hepatic tumors. AJR Am J Roentgenol 177(4):799–805PubMed Tanaka S, Ioka T, Oshikawa O, Hamada Y, Yoshioka F (2001) Dynamic sonography of hepatic tumors. AJR Am J Roentgenol 177(4):799–805PubMed
17.
go back to reference Oudkerk M, Torres CG, Song B, Konig M, Grimm J, Fernandez-Cuadrado J, Op de Beeck B, Marquardt M, van Dijk P, de Groot JC (2002) Characterization of liver lesions with mangafodipir trisodium-enhanced MR imaging: multicenter study comparing MR and dual-phase spiral CT. Radiology 223(2):517–524PubMedCrossRef Oudkerk M, Torres CG, Song B, Konig M, Grimm J, Fernandez-Cuadrado J, Op de Beeck B, Marquardt M, van Dijk P, de Groot JC (2002) Characterization of liver lesions with mangafodipir trisodium-enhanced MR imaging: multicenter study comparing MR and dual-phase spiral CT. Radiology 223(2):517–524PubMedCrossRef
18.
go back to reference von Herbay A, Vogt C, Willers R, Haussinger D (2004) Real-time imaging with the sonographic contrast agent SonoVue: differentiation between benign and malignant hepatic lesions. J Ultrasound Med 23(12):1557–1568 von Herbay A, Vogt C, Willers R, Haussinger D (2004) Real-time imaging with the sonographic contrast agent SonoVue: differentiation between benign and malignant hepatic lesions. J Ultrasound Med 23(12):1557–1568
19.
go back to reference Quaia E, Calliada F, Bertolotto M, Rossi S, Garioni L, Rosa L, Pozzi-Mucelli R (2004) Characterization of focal liver lesions with contrast-specific US modes and a sulfur hexafluoride-filled microbubble contrast agent: diagnostic performance and confidence. Radiology 232(2):420–430PubMedCrossRef Quaia E, Calliada F, Bertolotto M, Rossi S, Garioni L, Rosa L, Pozzi-Mucelli R (2004) Characterization of focal liver lesions with contrast-specific US modes and a sulfur hexafluoride-filled microbubble contrast agent: diagnostic performance and confidence. Radiology 232(2):420–430PubMedCrossRef
20.
go back to reference Klein D, Jenett M, Gassel HJ, Sandstede J, Hahn D (2004) Quantitative dynamic contrast-enhanced sonography of hepatic tumors. Eur Radiol 14(6):1082–1091PubMedCrossRef Klein D, Jenett M, Gassel HJ, Sandstede J, Hahn D (2004) Quantitative dynamic contrast-enhanced sonography of hepatic tumors. Eur Radiol 14(6):1082–1091PubMedCrossRef
21.
go back to reference Yoshikawa J, Matsui O, Takashima T, Ida M, Takanaka T, Kawamura I, Kakuda K, Miyata S (1988) Fatty metamorphosis in hepatocellular carcinoma: radiologic features in 10 cases. AJR Am J Roentgenol 151(4):717–720PubMed Yoshikawa J, Matsui O, Takashima T, Ida M, Takanaka T, Kawamura I, Kakuda K, Miyata S (1988) Fatty metamorphosis in hepatocellular carcinoma: radiologic features in 10 cases. AJR Am J Roentgenol 151(4):717–720PubMed
22.
go back to reference Gaiani S, Celli N, Piscaglia F, Cecilioni L, Losinno F, Giangregorio F, Mancini M, Pini P, Fornari F, Bolondi L (2004) Usefulness of contrast-enhanced perfusional sonography in the assessment of hepatocellular carcinoma hypervascular at spiral computed tomography. J Hepatol 41(3):421–426PubMedCrossRef Gaiani S, Celli N, Piscaglia F, Cecilioni L, Losinno F, Giangregorio F, Mancini M, Pini P, Fornari F, Bolondi L (2004) Usefulness of contrast-enhanced perfusional sonography in the assessment of hepatocellular carcinoma hypervascular at spiral computed tomography. J Hepatol 41(3):421–426PubMedCrossRef
23.
go back to reference Giorgio A, Ferraioli G, Tarantino L, de Stefano G, Scala V, Scarano F, Coppola C, Del Viscovo L (2004) Contrast-enhanced sonographic appearance of hepatocellular carcinoma in patients with cirrhosis: comparison with contrast-enhanced helical CT appearance. AJR Am J Roentgenol 183(5):1319–1326PubMed Giorgio A, Ferraioli G, Tarantino L, de Stefano G, Scala V, Scarano F, Coppola C, Del Viscovo L (2004) Contrast-enhanced sonographic appearance of hepatocellular carcinoma in patients with cirrhosis: comparison with contrast-enhanced helical CT appearance. AJR Am J Roentgenol 183(5):1319–1326PubMed
24.
go back to reference Nicolau C, Catala V, Vilana R, Gilabert R, Bianchi L, Sole M, Pages M, Bru C (2004) Evaluation of hepatocellular carcinoma using SonoVue, a second generation ultrasound contrast agent: correlation with cellular differentiation. Eur Radiol 14(6):1092–1099PubMedCrossRef Nicolau C, Catala V, Vilana R, Gilabert R, Bianchi L, Sole M, Pages M, Bru C (2004) Evaluation of hepatocellular carcinoma using SonoVue, a second generation ultrasound contrast agent: correlation with cellular differentiation. Eur Radiol 14(6):1092–1099PubMedCrossRef
Metadata
Title
Characterization of focal liver lesions: comparative study of contrast-enhanced ultrasound versus spiral computed tomography
Authors
V. Catala
C. Nicolau
R. Vilana
M. Pages
L. Bianchi
M. Sanchez
C. Bru
Publication date
01-04-2007
Publisher
Springer-Verlag
Published in
European Radiology / Issue 4/2007
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-006-0444-6

Other articles of this Issue 4/2007

European Radiology 4/2007 Go to the issue