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Spada S, Arlt S, De Felice D, England GCW, Russo M. Digital postprocessing analysis of prostatic perfusion in neutered dogs. Vet Radiol Ultrasound 2024; 65:208-218. [PMID: 38363188 DOI: 10.1111/vru.13343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/06/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
B-mode ultrasound is routinely performed to evaluate the prostate gland in neutered dogs, although, the detection of malignancies may be challenging. Contrast-enhanced ultrasound (CEUS) has shown to be useful for the assessment of prostatic perfusion in normal and diseased dogs, although the interpretation of contrast ultrasonographic features may still be subjective. A quantitative tool for evaluating prostatic perfusion might improve the reliability of the results in terms of early detection of prostate neoplasia in neutered dogs. The present study aimed to evaluate the applicability of a postprocessing analysis tool to CEUS of the prostate in healthy neutered dogs, to provide quantitative measurements, and to study the influence of individual characteristics on prostatic regression. Twenty-three neutered dogs underwent a B-mode and CEUS examination of the prostate to acquire data about prostatic morphology and microcirculation. The prostate was imaged using a 5-7.5 MHz linear transducer and contrast was administered intravenously. Videoclips were analyzed by using Qontrast software and a postprocessing digital analysis tool (ImageJ) to measure perfusion peak intensity, time to peak, and vascularization ratio at the moment of the peak, which were then related to body weight, age, and time elapsed since orchiectomy. Correlation tests revealed higher vascularization in younger compared with older dogs (P < .05) and in smaller compared with larger dogs (P < .05). Time elapsed since orchiectomy (P > .05) did not affect prostatic perfusion. Contrast-enhanced ultrasound and the postprocessing analysis tool ImageJ allowed analysis of vascular perfusion in all dogs and have the potential to improve the diagnostic possibilities for andrological examination.
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Affiliation(s)
- Stefano Spada
- Department of Veterinary Medicine and Animal Production, University of Naples, Federico II, Naples, Italy
| | - Sebastian Arlt
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Daniela De Felice
- Department of Veterinary Medicine and Animal Production, University of Naples, Federico II, Naples, Italy
| | - Gary C W England
- School of Veterinary Medicine and Science, University of Nottingham, College Road, Sutton Bonington, Leicestershire, UK
| | - Marco Russo
- Department of Veterinary Medicine and Animal Production, University of Naples, Federico II, Naples, Italy
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Krolak C, Dighe M, Clark A, Shumaker M, Yeung R, Barr RG, Kono Y, Averkiou M. Quantification of Hepatocellular Carcinoma Vascular Dynamics With Contrast-Enhanced Ultrasound for LI-RADS Implementation. Invest Radiol 2024; 59:337-344. [PMID: 37725492 PMCID: PMC10939991 DOI: 10.1097/rli.0000000000001022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
OBJECTIVE The aim of this study is to describe a comprehensive contrast-enhanced ultrasound (CEUS) imaging protocol and analysis method to implement CEUS LI-RADS (Liver Imaging Reporting and Data System) in a quantifiable manner. The methods that are validated with a prospective single-center study aim to simplify CEUS LI-RADS evaluation, remove observer bias, and potentially improve the sensitivity of CEUS LI-RADS. MATERIALS AND METHODS This prospective single-center study enrolled patients with hepatocellular carcinoma (April 2021-June 2022; N = 31; mean age ± SD, 67 ± 6 years; 24 men/7 women). For each patient, at least 2 CEUS loops spanning over 5 minutes were collected for different lesion scan planes using an articulated arm to hold the transducer. Automatic respiratory gating and motion compensation algorithms removed errors due to breathing motion. The long axis of the lesion was measured in the contrast and fundamental images to capture nodule size. Parametric processing of time-intensity curve analysis on linearized data provided quantifiable information of the wash-in and washout dynamics via rise time ( RT ) and degree of washout ( DW ) parameters extracted from the time-intensity curve, respectively. A Welch t test was performed between lesion and parenchyma RT for each lesion to confirm statistically significant differences. P values for bootstrapped 95% confidence intervals of the relative degree of washout ( rDW ), ratio of DW between the lesion and surrounding parenchyma, were computed to quantify lesion washout. Coefficient of variation (COV) of RT , DW , and rDW was calculated for each patient between injections for both the lesion and surrounding parenchyma to gauge reproducibility of these metrics. Spearman rank correlation tests were performed among size, RT , DW , and rDW values to evaluate statistical dependence between the variables. RESULTS The mean ± SD lesion diameter was 23 ± 8 mm. The RT for all lesions, capturing arterial phase hyperenhancement, was shorter than that of surrounding liver parenchyma ( P < 0.05). All lesions also demonstrated significant ( P < 0.05) but variable levels of washout at both 2-minute and 5-minute time points, quantified in rDW . The COV of RT for the lesion and surrounding parenchyma were both 11%, and the COV of DW and rDW at 2 and 5 minutes ranged from 22% to 31%. Statistically significant relationships between lesion and parenchyma RT and between lesion RT and lesion DW at the 2- and 5-minute time points were found ( P < 0.05). CONCLUSIONS The imaging protocol and analysis method presented provide robust, quantitative metrics that describe the dynamic vascular patterns of LI-RADS 5 lesions classified as hepatocellular carcinomas. The RT of the bolus transit quantifies the arterial phase hyperenhancement, and the DW and rDW parameters quantify the washout from linearized CEUS intensity data. This unique methodology is able to implement the CEUS-LIRADS scheme in a quantifiable manner for the first time and remove its existing issues of currently being qualitative and suffering from subjective evaluations.
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Affiliation(s)
- Connor Krolak
- University of Washington Department of Bioengineering, Seattle, USA
| | - Manjiri Dighe
- University of Washington Department of Radiology, Seattle, USA
| | - Alicia Clark
- University of Washington Department of Bioengineering, Seattle, USA
| | - Marissa Shumaker
- University of Washington Department of Bioengineering, Seattle, USA
| | - Raymond Yeung
- University of Washington Department of Surgery, Seattle, USA
| | | | - Yuko Kono
- University of California at San Diego Department of Radiology, San Diego, USA
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Cerrito L, Ainora ME, Cuccia G, Galasso L, Mignini I, Esposto G, Garcovich M, Riccardi L, Gasbarrini A, Zocco MA. Dynamic Contrast-Enhanced Ultrasound in the Prediction of Advanced Hepatocellular Carcinoma Response to Systemic and Locoregional Therapies. Cancers (Basel) 2024; 16:551. [PMID: 38339302 PMCID: PMC10854581 DOI: 10.3390/cancers16030551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Hepatocellular carcinoma (HCC) is the most frequent primary liver cancer and the sixth most common malignant tumor in the world, with an incidence of 2-8% per year in patients with hepatic cirrhosis or chronic hepatitis. Despite surveillance schedules, it is sometimes diagnosed at an advanced stage, requiring complex therapeutic efforts with both locoregional and systemic treatments. Traditional radiological tools (computed tomography and magnetic resonance) are used for the post-treatment follow-up of HCC. The first follow-up imaging is performed at 4 weeks after resection or locoregional treatments, or after 3 months from the beginning of systemic therapies, and subsequently every 3 months for the first 2 years. For this reason, these radiological methods do not grant the possibility of an early distinction between good and poor therapeutic response. Contrast-enhanced ultrasound (CEUS) and dynamic contrast-enhanced ultrasound (DCE-US) have gained the interest of several researchers for their potential role in the early assessment of response to locoregional treatments (chemoembolization) or antiangiogenic therapies in patients with advanced HCC. In fact, DCE-US, through a quantitative analysis performed by specific software, allows the construction of time-intensity curves, providing an evaluation of the parameters related to neoplastic tissue perfusion and its potential changes following therapies. It has the invaluable advantage of being easily repeatable, minimally invasive, and able to grant important evaluations regarding patients' survival, essential for well-timed therapeutic changes in case of unsatisfying response, and eventual further treatment planning.
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Affiliation(s)
- Lucia Cerrito
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy (M.E.A.); (G.C.); (G.E.); (M.G.); (L.R.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy; (L.G.); (I.M.)
| | - Maria Elena Ainora
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy (M.E.A.); (G.C.); (G.E.); (M.G.); (L.R.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy; (L.G.); (I.M.)
| | - Giuseppe Cuccia
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy (M.E.A.); (G.C.); (G.E.); (M.G.); (L.R.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy; (L.G.); (I.M.)
| | - Linda Galasso
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy; (L.G.); (I.M.)
| | - Irene Mignini
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy; (L.G.); (I.M.)
| | - Giorgio Esposto
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy (M.E.A.); (G.C.); (G.E.); (M.G.); (L.R.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy; (L.G.); (I.M.)
| | - Matteo Garcovich
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy (M.E.A.); (G.C.); (G.E.); (M.G.); (L.R.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy; (L.G.); (I.M.)
| | - Laura Riccardi
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy (M.E.A.); (G.C.); (G.E.); (M.G.); (L.R.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy; (L.G.); (I.M.)
| | - Antonio Gasbarrini
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy (M.E.A.); (G.C.); (G.E.); (M.G.); (L.R.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy; (L.G.); (I.M.)
| | - Maria Assunta Zocco
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy (M.E.A.); (G.C.); (G.E.); (M.G.); (L.R.); (A.G.)
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy; (L.G.); (I.M.)
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Wu JY, Bai XM, Wang H, Xu Q, Wang S, Wu W, Yan K, Yang W. The Perfusion Features of Recurrent Hepatocellular Carcinoma After Radiofrequency Ablation Using Contrast-Enhanced Ultrasound and Pathological Stemness Evaluation: Compared to Initial Tumors. Front Oncol 2020; 10:1464. [PMID: 32983980 PMCID: PMC7479182 DOI: 10.3389/fonc.2020.01464] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/09/2020] [Indexed: 12/14/2022] Open
Abstract
Objective: To investigate the perfusion features of local recurrence in hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) with contrast-enhanced ultrasound (CEUS) and pathological correlation, as well as to compare with those of initial HCC. Methods: From 2010 to 2018, 42 patients with recurrent HCC after RFA were enrolled in this study. The initial HCC patients included 32 males and 10 females with an average age of 58.2 ± 8.1 years. The CEUS images for initial HCC lesions and local recurrence after RFA were compared. The perfusion features were analyzed, including enhancement time, process, boundary, morphology, washout time, washout degree, feeding vessels, and internal necrosis. H&E staining and CD133/EpCAM staining were performed with biopsy samples for the stemness study. Results: According to CEUS, 59.5% of initial HCC lesions had centripetal enhancement, and 61.9% of recurrent HCC lesions had homogeneous enhancement in the arterial phase (p < 0.001). A total of 73.8% of initial HCC lesions had well-defined margins at the peak, and 81.0% of recurrent HCC lesions had poorly defined margins (p < 0.001). A total of 78.6% of initial HCC lesions had regular morphology at the peak, and 83.3% of recurrent HCC lesions were irregular (p < 0.001). Feeding vessels were more frequently found in initial HCC lesion (71.4%) than in recurrent HCCs (38.1%, p = 0.002). In the late phase, 60% of initial HCCs had marked washout while 83.3% of recurrent HCC lesion had marked washout (p = 0.019). A total of 31.3% of the initial HCC lesions had internal necrosis areas while only 7.1% of recurrent HCC lesions had internal necrosis areas (p = 0.035). In tumors 3-5 cm in size, the washout time of recurrent HCCs was shorter than that of initial HCCs (50.3 ± 13.5 s vs. 75.6 ± 45.8 s, p = 0.013). Pathological staining showed that the tumor stem cell markers (CD133 and EpCAM) were both highly expressed in recurrent samples compared with initial tumor samples (CD133+: 19 vs. 5%, p = 0.002; EpCAM+:15 vs. 6%, p = 0.005). Conclusions: Recurrent HCC after RFA had more homogeneous enhancement with a poorly defined border, marked washout, and fewer less feeding vessels and inner necrosis areas compared to initial HCC. The stemness study also found upregulated stemness in recurrent HCC. These specific features might be related to the aggressive biological behavior of recurrent HCC.
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Affiliation(s)
- Jin-Yu Wu
- Department of Ultrasound, the First Hospital of Harbin, Harbin, China.,Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital and Institute, Beijing, China
| | - Xiu-Mei Bai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital and Institute, Beijing, China
| | - Hong Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital and Institute, Beijing, China
| | - Qian Xu
- Department of Ultrasound, the First Hospital of Harbin, Harbin, China
| | - Song Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital and Institute, Beijing, China
| | - Wei Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital and Institute, Beijing, China
| | - Kun Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital and Institute, Beijing, China
| | - Wei Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Ultrasound, Peking University Cancer Hospital and Institute, Beijing, China
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Ling W, Wang M, Ma X, Qiu T, Li J, Lu Q, Luo Y. The preliminary application of liver imaging reporting and data system (LI-RADS) with contrast-enhanced ultrasound (CEUS) on small hepatic nodules (≤ 2cm). J Cancer 2018; 9:2946-2952. [PMID: 30123363 PMCID: PMC6096371 DOI: 10.7150/jca.25539] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/26/2018] [Indexed: 02/05/2023] Open
Abstract
To evaluate the diagnostic accuracy of liver imaging reporting and data system (LI-RADS) with contrast-enhanced ultrasound (CEUS) for patients at risk for hepatocellular carcinoma with hepatic nodules (≤2cm). We retrospectively evaluated 56 CEUS exam records of hepatic nodules (≤2cm) performed between January 2015 and July 2016 at West China hospital. Each nodule was classified into a LI-RADS-CEUS category by two radiologists according to imaging features. The ultimate CEUS categories were then compared with pathological reports and their correlation was then calculated. Inter-observer agreement for LI-RADS between reader A and B was κ, 0.690, illustrating good consistency. The diagnostic accuracy of LR-5 on hepatocellular carcinoma (HCC) was 86.49% but 11.11% for LR-M. LI-RADS-CEUS is a potential standardized categorization system for high-risk HCC patients but might also increase the false-negative diagnosis of nodules of less than 2cm.
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Affiliation(s)
- Wenwu Ling
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Manni Wang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xuelei Ma
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Tingting Qiu
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Jiawu Li
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Qiang Lu
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yan Luo
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu 610041, China
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Tian W, Lu J, Jiao D, Cong Z. An evaluation of the clinical diagnostic value of contrast-enhanced ultrasound combined with contrast-enhanced computed tomography in space-occupying lesions of the kidney. Onco Targets Ther 2017; 10:3493-3499. [PMID: 28761358 PMCID: PMC5522827 DOI: 10.2147/ott.s135500] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND There are a variety of space-occupying lesions of the kidney, and the benign lesions may be difficult to differentiate from the malignant ones. Therefore, an accurate judgment of the benign and malignant nature of the space-occupying lesions of the kidney is of high importance for the treatment and prognosis of these patients. OBJECTIVE To evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with contrast-enhanced computed tomography (CECT) in space-occupying lesions of the kidney. DATA AND METHODS Three hundred and sixty-seven patients with space-occupying lesions of the kidney (378 lesions) were examined by CEUS and CECT, respectively, then, a combined diagnosis was made after the combination of CEUS and CECT by a multidisciplinary team. The diagnoses from the three methods were compared. The pathological results were taken as the gold standard. The sensitivity, specificity, positive and negative predictive values and area under the receiver operating characteristic (ROC) curve were calculated for the three methods. Thus, the diagnostic value of the three methods was assessed. RESULTS Of the 378 lesions examined, there were 301 malignant lesions and 77 benign lesions. The combined examination revealed 303 malignant lesions, with 9 benign lesions mistakenly diagnosed as malignant ones; thus, the misdiagnosis rate was 11.7%. By using the combined examination, 75 benign lesions were diagnosed, with the missed diagnosis of 7 malignant lesions, so the missed diagnosis rate was 2.3%. The sensitivity, specificity, positive and negative predictive values and area under the ROC curve with the combined examination of CEUS and CECT were 97.67% (0.950-0.989), 88.31% (0.785-0.942), 97.03% (0.942-0.985), 90.67% (0.811-0.958) and 0.930 (0.887-0.973), respectively. As compared with either CEUS or CECT alone, the difference in these indicators was of statistical significance (P<0.05). The combined examination greatly improved the sensitivity, specificity and accuracy of the diagnosis of the space-occupying lesions of the kidney. CONCLUSION CEUS and CECT each have advantages and disadvantages in the diagnosis of the space-occupying lesions of the kidney. The two techniques can be used in combination to compensate for the respective defects. More salient benefits can be reaped from the combined examination than from either technique used alone.
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Affiliation(s)
- Wen Tian
- Department of Blood Transfusion, The Second Hospital of Jilin University
| | - Jianbo Lu
- Department of Ultrasound, Affiliated Hospital of Changchun University of Traditional Chinese Medicine
| | - Dan Jiao
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Zhibin Cong
- Department of Ultrasound, Affiliated Hospital of Changchun University of Traditional Chinese Medicine
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Wendl C, Janke M, Jung W, Stroszczysnski C, Jung E. Contrast-enhanced ultrasound with perfusion analysis for the identification of malignant and benign tumours of the thyroid gland. Clin Hemorheol Microcirc 2016; 63:113-21. [DOI: 10.3233/ch-151966] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Chou R, Cuevas C, Fu R, Devine B, Wasson N, Ginsburg A, Zakher B, Pappas M, Graham E, Sullivan SD. Imaging Techniques for the Diagnosis of Hepatocellular Carcinoma: A Systematic Review and Meta-analysis. Ann Intern Med 2015; 162:697-711. [PMID: 25984845 DOI: 10.7326/m14-2509] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Several imaging modalities are available for diagnosis of hepatocellular carcinoma (HCC). PURPOSE To evaluate the test performance of imaging modalities for HCC. DATA SOURCES MEDLINE (1998 to December 2014), the Cochrane Library Database, Scopus, and reference lists. STUDY SELECTION Studies on test performance of ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI). DATA EXTRACTION One investigator abstracted data, and a second investigator confirmed them; 2 investigators independently assessed study quality and strength of evidence. DATA SYNTHESIS Few studies have evaluated imaging for HCC in surveillance settings. In nonsurveillance settings, sensitivity for detection of HCC lesions was lower for ultrasonography without contrast than for CT or MRI (pooled difference based on direct comparisons, 0.11 to 0.22), and MRI was associated with higher sensitivity than CT (pooled difference, 0.09 [95% CI, 0.07 to 12]). For evaluation of focal liver lesions, there were no clear differences in sensitivity among ultrasonography with contrast, CT, and MRI. Specificity was generally 0.85 or higher across imaging modalities, but this item was not reported in many studies. Factors associated with lower sensitivity included use of an explanted liver reference standard, and smaller or more well-differentiated HCC lesions. For MRI, sensitivity was slightly higher for hepatic-specific than nonspecific contrast agents. LIMITATIONS Only English-language articles were included, there was statistical heterogeneity in pooled analyses, and costs were not assessed. Most studies were conducted in Asia and had methodological limitations. CONCLUSION CT and MRI are associated with higher sensitivity than ultrasonography without contrast for detection of HCC; sensitivity was higher for MRI than CT. For evaluation of focal liver lesions, the sensitivities of ultrasonography with contrast, CT, and MRI for HCC are similar. PRIMARY FUNDING SOURCE Agency for Healthcare Research and Quality. ( PROSPERO CRD42014007016).
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Affiliation(s)
- Roger Chou
- From Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon; University of Washington Centers for Comparative and Health Systems Effectiveness (CHASE) Alliance, Seattle, Washington; and Mayo Medical School, Rochester, Minnesota
| | - Carlos Cuevas
- From Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon; University of Washington Centers for Comparative and Health Systems Effectiveness (CHASE) Alliance, Seattle, Washington; and Mayo Medical School, Rochester, Minnesota
| | - Rongwei Fu
- From Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon; University of Washington Centers for Comparative and Health Systems Effectiveness (CHASE) Alliance, Seattle, Washington; and Mayo Medical School, Rochester, Minnesota
| | - Beth Devine
- From Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon; University of Washington Centers for Comparative and Health Systems Effectiveness (CHASE) Alliance, Seattle, Washington; and Mayo Medical School, Rochester, Minnesota
| | - Ngoc Wasson
- From Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon; University of Washington Centers for Comparative and Health Systems Effectiveness (CHASE) Alliance, Seattle, Washington; and Mayo Medical School, Rochester, Minnesota
| | - Alexander Ginsburg
- From Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon; University of Washington Centers for Comparative and Health Systems Effectiveness (CHASE) Alliance, Seattle, Washington; and Mayo Medical School, Rochester, Minnesota
| | - Bernadette Zakher
- From Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon; University of Washington Centers for Comparative and Health Systems Effectiveness (CHASE) Alliance, Seattle, Washington; and Mayo Medical School, Rochester, Minnesota
| | - Miranda Pappas
- From Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon; University of Washington Centers for Comparative and Health Systems Effectiveness (CHASE) Alliance, Seattle, Washington; and Mayo Medical School, Rochester, Minnesota
| | - Elaine Graham
- From Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon; University of Washington Centers for Comparative and Health Systems Effectiveness (CHASE) Alliance, Seattle, Washington; and Mayo Medical School, Rochester, Minnesota
| | - Sean D. Sullivan
- From Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland, Oregon; University of Washington Centers for Comparative and Health Systems Effectiveness (CHASE) Alliance, Seattle, Washington; and Mayo Medical School, Rochester, Minnesota
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Qi-hua X, Chen Z, Jian-gang Z, Da-zhong Z, Yong-qiang Z. Comparison of contrast-enhanced ultrasonography and contrast-enhanced MRI for the assessment of vascularization of hydroxyapatite orbital implants. Clin Imaging 2014; 38:616-20. [DOI: 10.1016/j.clinimag.2014.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 04/24/2014] [Accepted: 05/13/2014] [Indexed: 10/25/2022]
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