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Intensity-Based Assessment of Microbubble-Enhanced Ultrasonography: Phase-Related Diagnostic Ability for Cellular Differentiation of Hepatocellular Carcinoma.

Abstract
This prospective study aimed to elucidate the effect of phase-related quantitative parameters of contrast-enhanced ultrasound (CEUS) with perflubutane microbubble agent to assess the cellular differentiation of hepatocellular carcinoma (HCC). Intensity was analyzed in 94 lesions (19.4 ± 4.9 mm, 86 patients), 47 well-differentiated HCCs (wHCCs) and 47 moderately-differentiated HCCs (mHCCs): I(e) (early phase) = I(te) (tumor) - I(le) (liver), I(p) (post-vascular phase) = I(tp) (tumor) - I(lp) (liver), I(ep) = I(e) - I(p). The area under the receiver operating characteristic curve with the best cutoff value (I(e), 13.2, I(p), -4.5, I(ep), 21.3) for discriminating between wHCC and mHCC was 0.6922 for Ie, 0.7680 for Ip and 0.7925 for Iep, which indicated a significantly greater ability to differentiate between wHCC and mHCC compared with visual/qualitative assessment (early phase, 0.6170, p = 0.04; post-vascular phase, 0.6702, p = 0.01; both phases, 0.7021, p = 0.04). In conclusion, I(ep) was found to have the highest diagnostic ability, suggesting it is a promising parameter for the cellular differentiation of HCCs with CEUS.
AuthorsTakayuki Kondo, Hitoshi Maruyama, Soichiro Kiyono, Tadashi Sekimoto, Taro Shimada, Masanori Takahashi, Sadahisa Ogasawara, Eiichiro Suzuki, Yoshihiko Ooka, Akinobu Tawada, Tetsuhiro Chiba, Fumihiko Kanai, Osamu Yokosuka
JournalUltrasound in medicine & biology (Ultrasound Med Biol) Vol. 41 Issue 12 Pg. 3079-87 (Dec 2015) ISSN: 1879-291X [Electronic] England
PMID26371403 (Publication Type: Journal Article)
CopyrightCopyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
Chemical References
  • Contrast Media
  • Fluorocarbons
  • perfluorobutane
Topics
  • Aged
  • Carcinoma, Hepatocellular (diagnostic imaging, physiopathology)
  • Cell Differentiation (physiology)
  • Contrast Media
  • Female
  • Fluorocarbons
  • Humans
  • Image Enhancement
  • Liver (diagnostic imaging, physiopathology)
  • Liver Neoplasms (diagnostic imaging, physiopathology)
  • Male
  • Microbubbles
  • Prospective Studies
  • Reproducibility of Results
  • Ultrasonography

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