Dynamic Contrast-Enhanced Ultrasonography Combined With LR-M Classification Criteria for Differentiating Malignant Liver Nodules at High Risk for Hepatocellular Carcinoma.

Qiu, S ; Ding, J ; et al.

In: Ultrasound in medicine & biology, Jg. 50 (2024-07-01), Heft 7, S. 1028-1033

academicJournal

Objective: We aimed to investigate the value of quantitative parameters derived from dynamic contrast-enhanced ultrasonography (DCE-US) and a combination of these quantitative parameters with the LR-M classification criteria in distinguishing hepatocellular carcinoma (HCC) nodules and non-HCC malignancies.

Methods: HCC and non-HCC malignant nodules were grouped using pathologic results, and each nodule was classified using CEUS LI-RADS 2017. Quantitative CEUS analysis of each nodule was performed using VueBox, and quantitative parameters were compared between the HCC and non-HCC groups. The diagnostic efficacy of the LR-5 category for HCC was analyzed using the LR-M classification criteria along with time-related quantitative parameters.

Results: Of the 190 malignant liver nodules, 137 and 53 were HCCs and non-HCC malignancies, respectively. The median values of quantitative parameters RT (rise time), TTP (time to peak), mTTl (mean transit time local), and FT (fall time) in the non-HCC malignant group were lower than those in the HCC group, with p < 0.05. There was a statistically significant difference in WiAUC (wash-in area under the curve), WoAUC (wash-out area under the curve), WiWoAUC (wash-in and wash-out area under the curve), and WoR (wash-out rate) values between HCC and non-HCC malignant groups, with p < 0.05. Using LR-M washout time <60 s and FT ≤21.2 s as the new diagnostic standard, the LR-5 category showed a sensitivity of 83.9%, specificity of 96.2%, and positive predictive value of 98.3% for HCC diagnosis.

Conclusion: DCE-US can facilitate the distinction of HCCs and non-HCC malignancies. Non-HCC malignancies present with earlier peak enhancement and more rapid and marked washout than HCC nodules. The combination of the LR-M classification criteria and FT ≤21.2 s can significantly improve the diagnostic sensitivity of the LR-5 category for HCC.

Competing Interests: Conflict of interest The authors declare no conflict of interest.

Titel:	Dynamic Contrast-Enhanced Ultrasonography Combined With LR-M Classification Criteria for Differentiating Malignant Liver Nodules at High Risk for Hepatocellular Carcinoma.
Autor/in / Beteiligte Person:	Qiu, S ; Ding, J ; Wang, Y ; Zhou, H ; Zhao, L ; Zhou, Y ; Fu, Y ; Jing, X
Zeitschrift:	Ultrasound in medicine & biology, Jg. 50 (2024-07-01), Heft 7, S. 1028-1033
Veröffentlichung:	Oxford, New York, Pergamon Press., 2024
Medientyp:	academicJournal
ISSN:	1879-291X (electronic)
DOI:	10.1016/j.ultrasmedbio.2024.03.016
Schlagwort:	Humans Male Female Middle Aged Diagnosis, Differential Aged Liver diagnostic imaging Image Enhancement methods Adult Retrospective Studies Sensitivity and Specificity Carcinoma, Hepatocellular diagnostic imaging Liver Neoplasms diagnostic imaging Contrast Media Ultrasonography methods
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Ultrasound Med Biol] 2024 Jul; Vol. 50 (7), pp. 1028-1033. <i>Date of Electronic Publication: </i>2024 Apr 17. MeSH Terms: Carcinoma, Hepatocellular* / diagnostic imaging ; Liver Neoplasms* / diagnostic imaging ; Contrast Media* ; Ultrasonography* / methods ; Humans ; Male ; Female ; Middle Aged ; Diagnosis, Differential ; Aged ; Liver / diagnostic imaging ; Image Enhancement / methods ; Adult ; Retrospective Studies ; Sensitivity and Specificity Contributed Indexing: Keywords: Contrast-enhanced ultrasound; Differential diagnosis; Dynamic contrast-enhanced ultrasound; Hepatocellular carcinoma; Liver Imaging Reporting and Data System Substance Nomenclature: 0 (Contrast Media) Entry Date(s): Date Created: 20240417 Date Completed: 20240601 Latest Revision: 20240601 Update Code: 20240602

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