Strobel, D. and Jung, Ernst-Michael and Ziesch, M. and Praktiknjo, M. and Link, A. and Dietrich, C. F. and Klinger, C. and Schultheiss, M. and Jesper, D. and Schellhaas, Barbara (2021) Real-life assessment of standardized contrast-enhanced ultrasound (CEUS) and CEUS algorithms (CEUS LI-RADS (R)/ESCULAP) in hepatic nodules in cirrhotic patients-a prospective multicenter study. EUROPEAN RADIOLOGY, 31 (10). pp. 7614-7625. ISSN 0938-7994, 1432-1084
Full text not available from this repository. (Request a copy)Abstract
Objectives Hepatocellular carcinoma (HCC) can be diagnosed non-invasively with contrast-enhanced ultrasound (CEUS) in cirrhosis if the characteristic pattern of arterial phase hyperenhancement followed by hypoenhancement is present. Recent studies suggest that diagnosis based on this "hyper-hypo" pattern needs further refinement. This study compares the diagnostic accuracies of standardized CEUS for HCC according to the current guideline definition and following the newly developed CEUS algorithms (CEUS LI-RADS (R), ESCULAP) in a prospective multicenter real-life setting. Methods Cirrhotic patients with liver lesions on B-mode ultrasound were recruited prospectively from 04/2018 to 04/2019, and clinical and imaging data were collected. The CEUS standard included an additional examination point after 4-6 min in case of no washout after 3 min. The diagnostic accuracies of CEUS following the guidelines ("hyper-hypo" pattern), based on the examiner's subjective interpretation ("CEUS subjective"), and based on the CEUS algorithms ESCULAP and CEUS LI-RADS (R) were compared. Results In total, 470 cirrhotic patients were recruited in 43 centers. The final diagnosis was HCC in 378 cases (80.4%) according to the reference standard (histology 77.4%, MRI 16.4%, CT 6.2%). The "hyper-hypo" pattern yielded 74.3% sensitivity and 63% specificity. "CEUS subjective" showed a higher diagnostic accuracy (sensitivity, 91.5%; specificity, 67.4%; positive predictive value, 92%; negative predictive value, 66%). Sensitivity was higher for ESCULAP (95%) and "CEUS subjective" (91.5%) versus CEUS LI-RADS (R) (65.2%; p < 0.001). Specificity was highest for CEUS LI-RADS (R) (78.6%; p < 0.001). Conclusions CEUS has an excellent diagnostic accuracy for the non-invasive diagnosis of HCC in cirrhosis. CEUS algorithms may be a helpful refinement of the "hyper-hypo" pattern defined by current HCC guidelines.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | FOCAL LIVER-LESIONS; HEPATOCELLULAR-CARCINOMA; DIFFERENTIAL-DIAGNOSIS; 20 MM; RADS; GUIDELINES; ACCURACY; MANAGEMENT; RISK; Carcinoma; hepatocellular; Ultrasonography; Contrast media; Liver; Diagnostic imaging |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Sep 2022 08:21 |
| Last Modified: | 20 Sep 2022 08:21 |
| URI: | https://pred.uni-regensburg.de/id/eprint/47624 |
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