Abstract:
IM: To evaluate in a multicenter study whether the
sonographic characterization of focal liver lesions can
be improved using SonoVue®-enhancement; and to
compare this method with computed tomography (CT)
and magnetic resonance imaging (MRI).
METHODS: One hundred and thirty four patients with ne focal liver lesion detected in baseline ultrasound
(US) were examined with conventional US, contrast-
enhanced US (n = 134), contrast-enhanced CT (n =
115) and/or dynamic contrast-enhanced MRI (n = 70).
The lesions were classified as malignant, benign or
indeterminate and the type of lesion was determined.
The final diagnosis based on the combined information
of all imaging examinations, clinical information and
histology (n = 32) was used. Comparisons were made
to see whether the addition of contrast-enhanced US led
to the improvement of the characterization of doubtful
focal liver lesions.
RESULTS: In comparison with unenhanced US, SonoVue®
markedly improves sensitivity and specificity for the
characterization (malignant/benign) of focal liver lesions.
In comparison with CT and/or dynamic MRI, SonoVue®
-enhanced sonography applied for characterization
of focal liver lesions was 30.2% more sensitive in the
recognition of malignancy and 16.1% more specific in
the exclusion of malignancy and overall 22.9% more
accurate. In the subgroup with confirmative histology
available (n = 30), sensitivity was 95.5% (CEUS), 72.2%
(CT) and 81.8% (MRI), and specificity was 75.0% (CEUS),
37.5% (CT) and 42.9% (MRI). The sensitivity and
specificity of CEUS for the identification of focal nodular
hyperplasia (FNH) and hemangiomas was 100% and
87%, resulting in an accuracy of 94.5%.
CONCLUSION: SonoVue ® -enhanced sonography
emerges as the most sensitive, most specific and thus
most accurate imaging modality for the characterization
of focal liver lesions.
