Published in:
01-09-2014 | Hepatobiliary-Pancreas
Utility of contrast-enhanced ultrasound with perflubutane for diagnosing the macroscopic type of small nodular hepatocellular carcinomas
Published in: European Radiology | Issue 9/2014
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Objective
To clarify the diagnostic value of contrast-enhanced ultrasound (CEUS) with perflubutane in the macroscopic classification of small nodular hepatocellular carcinomas (HCCs).
Methods
A total of 99 surgically resected nodular HCCs with a maximum diameter of 3 cm or less were analysed. HCCs were macroscopically categorized as simple nodular (SN) and non-SN. CEUS findings were evaluated during the arterial phase (vascularity, level and shape of enhancement), portal phase (presence or absence of washout) and post-vascular phase (echo intensity and shape).
Results
Sixty-eight HCCs were categorized as SN and the remaining 31 were categorized as non-SN. For diagnosis of non-SN HCC, the areas under the receiver operating characteristic curve (A
z) value for the shape of enhancement in the late arterial phase and the shape of the post-vascular image were 0.824 (95 % confidence interval [CI] 0.721–0.895) and 0.878 (95 % CI 0.788–0.933), respectively. The A
z value for the combination of the shape of enhancement in the late arterial phase and the shape of the post-vascular image for the diagnosis of non-SN HCC was 0.907 (95 % CI 0.815–0.956), corresponding to a high diagnostic value.
Conclusion
CEUS can provide high-quality imaging assessment for determining the macroscopic classification of small nodular HCCs.
Key points
• Non-SN is one of the poor prognostic factors in patients with HCC
• Assessment of macroscopic type provides valuable information for the management of HCC
• CEUS can provide high-quality imaging assessment for macroscopic classification of HCC
• For non-SN HCC diagnosed using CEUS, hepatectomy is preferred as curative treatment